Individual
ERIC GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6446 E CENTRAL AVE # 252, WICHITA, KS 67206-1923
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-312363
MA
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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