Provider Demographics
NPI:1073974903
Name:GILMORE, ANDREW STEPHEN (RBT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:STEPHEN
Last Name:GILMORE
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1045 E PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4616
Mailing Address - Country:US
Mailing Address - Phone:619-201-2010
Mailing Address - Fax:619-243-7387
Practice Address - Street 1:1045 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4616
Practice Address - Country:US
Practice Address - Phone:619-201-2010
Practice Address - Fax:619-243-7387
Is Sole Proprietor?:No
Enumeration Date:2016-03-20
Last Update Date:2016-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst