Individual
SOPHIA GABRIELLE IZYDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
901 WHALEN RD STE A, VERONA, WI 53593-1766
(855) 444-5664
Mailing address
901 WHALEN RD STE A, VERONA, WI 53593-1766
(855) 444-5664
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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