Most Relevant Information
Provider Data
| NPI Number: | 1003591470 |
| Provider Name: | LEEBAN GULLED |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/21/2023 |
| Last Updated: | 06/21/2023 |
Provider Practice Location
1501 SOUTHCROSS DR W
BURNSVILLE
MN
553066938
Practice Location Phone/Fax
| Phone: | 9524561474 |
| Fax: |
Provider Mailing Location
1501 SOUTHCROSS DR W
BURNSVILLE
MN
553066938
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |