Individual
ELLIE GALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
310 E BROADWAY AVE, JACKSON, WY 83001-8636
(307) 257-5487
Mailing address
898 EVERETT PL APT 2, REXBURG, ID 83440-5463
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
14187307-2506
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/24/2022
Last updated
10/22/2024
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