Individual
SUSAN GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 RENAISSANCE DR STE 301, BUTLER, PA 16001-7612
(814) 460-6230
Mailing address
200 RENAISSANCE DR STE 301, BUTLER, PA 16001-7612
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001598
PA
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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