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1568117232
MICAH ASHIYA RUSSELL
DEARBORN, MI
NPI
1568117232
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-02-21
Last Update Date
2022-02-21
Business Address
MICAH ASHIYA RUSSELL
1360 PORTER ST
DEARBORN, MI 48124-2890
Phone number: 313-689-5188
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Mailing Address
MICAH ASHIYA RUSSELL
1360 PORTER ST
DEARBORN, MI 48124-2890
Phone number:
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