Jennifer Gough

NPI #1013502038 in Shakopee, Minnesota

Provider Information

NPI Number: 1013502038
Entity Type: Individual
Name: Jennifer Gough
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 2, 2021
Last Updated: Mar 2, 2021

Practice Location

Address: 4201 DEAN LAKES BLVD STE 160
City: Shakopee
State: Minnesota
ZIP Code: 55379-2863
Phone: (612) 509-6680

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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