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1427890474
GAVIN BLACK
SOUTH OGDEN, UT
NPI
1427890474
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: UT RBT-24-352986)
Enumeration Date
2024-06-11
Last Update Date
2024-06-11
Business Address
GAVIN BLACK RBT
6033 FASHION POINT DR
SOUTH OGDEN, UT 84403-4847
Phone number: 605-271-2690
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Mailing Address
GAVIN BLACK RBT
1105 W RUSSELL ST
SIOUX FALLS, SD 57104-1322
Phone number:
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