Most Relevant Information
Provider Data
| NPI Number: | 1003647520 |
| Provider Name: | NINOSCHTKA GORIS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/08/2024 |
| Last Updated: | 08/08/2024 |
Provider Practice Location
420 S SR7 #174
ROYAL PALM BEACH
FL
33414
Practice Location Phone/Fax
| Phone: | 5615689367 |
| Fax: |
Provider Mailing Location
4696 LUCERNE LAKES BLVD E APT 106
LAKE WORTH
FL
334678869
Provider Mailing Phone/Fax
| Phone: | 5615170372 |
| Fax: |