| NPI | 1275916363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEASA ANDROL Clinical Director 989-702-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-1416719) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2021-09-14 |