Individual
DIVINE GAMADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1775 ROOSEVELT RD, SAINT CLOUD, MN 56301-2207
(320) 774-3464
(320) 774-3465
Mailing address
1775 ROOSEVELT RD, SAINT CLOUD, MN 56301-2207
(320) 774-3464
(320) 774-3465
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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