Individual
ELLA GORGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36100 GENESEE LAKE RD, OCONOMOWOC, WI 53066-9201
(262) 470-4544
Mailing address
N114W15928 SYLVAN CIR APT 210, GERMANTOWN, WI 53022-3391
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
193-140
WI
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
03/18/2016
Last updated
03/17/2018
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