Healthcare Provider Details

I. General information

NPI: 1427904986
Provider Name (Legal Business Name): GENTLE GROWTH ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4044 WOODWORTH ST
DEARBORN MI
48126-3448
US

IV. Provider business mailing address

4044 WOODWORTH ST
DEARBORN MI
48126-3448
US

V. Phone/Fax

Practice location:
  • Phone: 313-580-7107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MRS. GHOFRAN MOHSEN
Title or Position: BEHAVIOR ANALYST
Credential: BCBA, MS
Phone: 313-375-0904