Individual
KIRK GORBACH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
4316 N WOODBURN ST, SHOREWOOD, WI 53211-1505
(231) 557-6423
Mailing address
4316 N WOODBURN ST, SHOREWOOD, WI 53211-1505
(231) 557-6423
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
61-140
WI
Other
Enumeration date
10/30/2013
Last updated
10/30/2013
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