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NPI Code Detail

MEDICARE: CHRISHON HURSE

MEDICARE: CHRISHON HURSE
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 : 1699628149
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISHON HURSE
Provider Business Mailing Address
First Line : 44670 ANN ARBOR RD W STE 130
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-4085
Country : US
Telephone Number : 313-278-4601
Fax Number :
Provider Business Practice Location Address
First Line : 44670 ANN ARBOR RD W STE 130
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-4085
Country : US
Telephone Number : 313-278-4601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ CHRISHON HURSE ” Practice Location

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