Individual
MARIA GUADALUPE UCAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
548 E CARDINAL GLEN DR, BLOOMINGTON, IN 47401-9492
(225) 333-7714
Mailing address
548 E CARDINAL GLEN DR, BLOOMINGTON, IN 47401-9492
(225) 333-7714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12044060
IN
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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