Individual
MS. GILLIAN NICOLE BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1233 SHERMAN DR, LONGMONT, CO 80501-6133
(720) 449-6676
Mailing address
1233 SHERMAN DR, LONGMONT, CO 80501-6133
(720) 449-6676
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814442229
—
CO
Enumeration date
05/17/2021
Last updated
05/17/2021
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