Individual
KYLE GANGL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
7001 E FISH LAKE RD STE 200, MAPLE GROVE, MN 55311-2844
(612) 260-5022
Mailing address
16630 72ND CT NE, OTSEGO, MN 55330-6554
(612) 741-3909
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/04/2024
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