Individual
LATISHA MARIE GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
8530 CLIFF CAMERON DR STE 140, CHARLOTTE, NC 28269-5906
(980) 202-7441
Mailing address
8530 CLIFF CAMERON DR STE 140, CHARLOTTE, NC 28269-5906
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49048
NC
Other
Enumeration date
11/21/2017
Last updated
11/12/2023
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