Individual
CLARA GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-104391
IL
225X00000X
Occupational Therapist
Primary
056016272
IL
Other
Enumeration date
07/31/2020
Last updated
10/16/2024
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