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Individual

DANIEL GULLETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-1239
(612) 331-9413
Mailing address
323 7TH ST SE APT 215, MINNEAPOLIS, MN 55414-1239

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
247200000X
Other Technician

Other

Enumeration date
11/02/2021
Last updated
11/23/2021
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