Individual
GARY MICHAEL STUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LBS, BCBA
Contact information
Practice address
193 MARKET ST, KINGSTON, PA 18704-5409
(570) 846-0455
Mailing address
193 MARKET ST, KINGSTON, PA 18704-5409
(570) 846-0455
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000078
PA
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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