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NPI Code Detail

MEDICARE: KRISTIN WIER MA. LLP. BCBA, LBA

MEDICARE: KRISTIN WIER MA. LLP. BCBA, LBA
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
1103T00000XPsychologistMI
2103K00000XBehavior Analyst740100022MI

General Provider Information

NPI Number : 1215159223
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN WIER MA. LLP. BCBA, LBA
Provider Business Mailing Address
First Line : 1651 E NICKERSON AVE
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-2469
Country : US
Telephone Number : 269-983-5833
Fax Number : 269-363-4630
Provider Business Practice Location Address
First Line : 1651 E NICKERSON AVE
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-2469
Country : US
Telephone Number : 269-983-5833
Fax Number : 269-363-4630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 02/01/2022

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