Individual
GATSBY BRUSVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
Mailing address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29706
IL
106S00000X
Behavior Technician
RBT-15-01607
IL
Other
Enumeration date
10/28/2016
Last updated
10/17/2019
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