Individual
DESIRAE GANTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
525 WILLOW BREEZE CT, ZEBULON, NC 27597-9703
(984) 302-5018
Mailing address
525 WILLOW BREEZE CT, ZEBULON, NC 27597-9703
(984) 302-5018
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-285978
NC
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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