Individual
ASHLEY LYNN GANATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT 1860482
Contact information
Practice address
1224 CENTURY OAKS DR, ELGIN, IL 60123-1325
(309) 255-5906
Mailing address
1224 CENTURY OAKS DR, ELGIN, IL 60123-1325
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-60482
IL
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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