Individual
DR. STACY GAYMAN GORESKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7916 NIWOT RD, NIWOT, CO 80503-7181
(720) 290-2707
Mailing address
8083 MEADOWDALE SQ, LONGMONT, CO 80503-8597
(303) 652-4950
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09977708
—
CO
Enumeration date
11/23/2010
Last updated
11/23/2010
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