Individual
GWENDLYN LEE PANZAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 SAINT LOUIS ST STE 1, EDWARDSVILLE, IL 62025-1979
(618) 226-4397
Mailing address
304 HUNTLEIGH DR, BELLEVILLE, IL 62220-3041
(618) 806-4148
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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