Healthcare Provider Details

I. General information

NPI: 1619352630
Provider Name (Legal Business Name): NINA LEMELIN M.S., B.C.B.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NINA HUNT M.S., B.C.B.A

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9070 N BLACK CANYON HWY
PHOENIX AZ
85051
US

IV. Provider business mailing address

27777 INKSTER RD STE 100
FARMINGTON HILLS MI
48334-5312
US

V. Phone/Fax

Practice location:
  • Phone: 623-850-8978
  • Fax:
Mailing address:
  • Phone: 855-772-8847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-19076
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: