JACQUAVIOUS DESHAWN BURT

BRIDGEPORT, MI
NPI1205564440
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy106S00000X Behavior Technician
(Licence: MI  630356139055)
Enumeration Date2022-08-14
Last Update Date2022-08-14
Business Address
JACQUAVIOUS DESHAWN BURT
6296 BRIDGEPORT VILLAGE SQUARE DR STE 2
BRIDGEPORT, MI 48722-9655
Phone number: 989-401-1239
Mailing Address
JACQUAVIOUS DESHAWN BURT
5039 VILLA LINDE PKWY STE 30
FLINT, MI 48532-3450
Phone number: 989-401-2244
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