Individual
CARLY BURISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA BCBA
Contact information
Practice address
2738 MANITOWOC RD, GREEN BAY, WI 54311-6630
(920) 904-0601
Mailing address
515 SUNRISE LN, GREEN BAY, WI 54301-1132
(920) 904-0601
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
WI
Other
Enumeration date
10/08/2018
Last updated
05/11/2022
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