Individual
MEGAN C GILDERSLEEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1136 S DELANO CT W STE B201, CHICAGO, IL 60605-3734
(219) 921-5747
Mailing address
5451 BUCKEYE AVE, PORTAGE, IN 46368-4205
(219) 921-5747
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58165
—
106S00000X
Behavior Technician
RBT-16-20966
IN
Other
Enumeration date
08/18/2020
Last updated
02/24/2022
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