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Individual

GABRIELLE DEPARASIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(570) 802-3099
Mailing address
9 BANKS AVE, MCADOO, PA 18237-2508
(570) 802-3099

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
272112814
PA
Enumeration date
09/19/2019
Last updated
05/17/2021
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