Individual
AMANDA GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3543 E MERIDIAN PARK LOOP STE C, WASILLA, AK 99654-7294
(907) 864-0099
(907) 864-0093
Mailing address
3543 E MERIDIAN PARK LOOP STE C, WASILLA, AK 99654-7294
(907) 864-0099
(907) 864-0093
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
191658
—
106E00000X
Assistant Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191658
LBA
AK
Enumeration date
03/07/2017
Last updated
04/14/2026
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