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Individual

GATWECH RUACH MIAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6701 CORPORATE DR # 4123, JOHNSTON, IA 50131-1659
(515) 220-7311
Mailing address
1570 SADLER DR, NORTH LIBERTY, IA 52317-8047
(319) 471-6685

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
118240
IA

Other

Enumeration date
06/25/2025
Last updated
07/07/2025
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