Healthcare Provider Details
I. General information
NPI: 1417786831
Provider Name (Legal Business Name): SONDER CENTER FOR NEURODEVELOPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2024
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5630 LAKE MICHIGAN DR STE B
ALLENDALE MI
49401-8115
US
IV. Provider business mailing address
2318 ROLLING GREEN PL
SAGINAW MI
48603-3740
US
V. Phone/Fax
- Phone: 616-566-1917
- Fax: 616-953-8815
- Phone: 989-770-0753
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AUBREY
PETTYPLACE
Title or Position: OWNER
Credential: MA, BCBA, LBA
Phone: 989-770-0753