JORDAN ETHAN BENJAMIN

KENTWOOD, MI
NPI1144881129
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
Enumeration Date2019-06-21
Last Update Date2019-06-21
Business Address
JORDAN ETHAN BENJAMIN BA
3361 36TH ST SE
KENTWOOD, MI 49512-2809
Phone number: 616-942-2522
Mailing Address
JORDAN ETHAN BENJAMIN BA
3361 36TH ST SE
KENTWOOD, MI 49512-2809
Phone number: