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NPI Code Detail

MEDICARE: RODERICK HOWARD

MEDICARE: RODERICK HOWARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1093108177
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODERICK HOWARD
Provider Business Mailing Address
First Line : 19853 OUTER DR
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2066
Country : US
Telephone Number : 313-406-5056
Fax Number :
Provider Business Practice Location Address
First Line : 19853 OUTER DR
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2066
Country : US
Telephone Number : 313-406-5056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2015
Last Update Date : 12/10/2024

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Directions to “ RODERICK HOWARD ” Practice Location

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