Individual
GINA MARIE NOGUERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23663 PARK ST, DEARBORN, MI 48124-2547
(313) 689-5188
Mailing address
6946 HARVARD LN, CANTON, MI 48187-2502
(248) 978-2932
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401002486
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/31/2017
Last updated
08/01/2024
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