Individual
GIANNA GAMBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4730 TABLE MESA DR, BOULDER, CO 80305-5560
(720) 408-0822
Mailing address
390 S 36TH ST, BOULDER, CO 80305-5439
(610) 551-3090
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
31374699
PA
Other
Enumeration date
04/20/2018
Last updated
04/20/2018
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