Individual
GINA SHAE CLARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR TECHNICIAN
Contact information
Practice address
721 14TH ST APT 1, ASTORIA, OR 97103-3951
(817) 733-4885
Mailing address
721 14TH ST APT 1, ASTORIA, OR 97103-3951
(817) 733-4885
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-257928
TX
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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