Individual
SAMANTHA GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
150 N SUNNY SLOPE RD STE 100, BROOKFIELD, WI 53005-4806
(262) 462-5660
Mailing address
6225 SMITH AVE STE 1001A, BALTIMORE, MD 21209-3626
(866) 727-8274
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
416-140
WI
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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