Individual
CHARMIN ROSE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2820 CAMINO DEL RIO S STE 100, SAN DIEGO, CA 92108-3822
(800) 434-8923
(615) 905-9200
Mailing address
2820 CAMINO DEL RIO S STE 100, SAN DIEGO, CA 92108-3822
(800) 434-8923
(615) 905-9200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62808
—
106E00000X
Assistant Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-17-7794
BEHAVIOR ANALYST CERTIFICATION BOARD, INC. (BACB)
—
01
—
1-22-62808
BEHAVIOR ANALYST CERTIFICATION BOARD, INC. (BACB)
CA
Enumeration date
07/25/2017
Last updated
07/21/2023
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