Most Relevant Information
Provider Data
| NPI Number: | 1003498833 |
| Provider Name: | SOPHIA VAN GUYSE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/21/2021 |
| Last Updated: | 04/21/2021 |
Provider Practice Location
10450 72ND AVE
PLEASANT PRAIRIE
WI
531582911
Practice Location Phone/Fax
| Phone: | 2626576453 |
| Fax: |
Provider Mailing Location
10835 32ND AVE
PLEASANT PRAIRIE
WI
531584114
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |