Individual
HALEY GORSUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3113 W BELTLINE HWY STE 300, MADISON, WI 53713-2934
(608) 819-6810
(312) 893-2118
Mailing address
1161 LAKE COOK RD, DEERFIELD, IL 60015-5649
(847) 498-5437
(312) 893-2118
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-163608
WI
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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