Healthcare Provider Details

I. General information

NPI: 1659001139
Provider Name (Legal Business Name): ALLIANCE BEHAVIOR CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 QUEENS CREEK DR W
FRANKENMUTH MI
48734-1300
US

IV. Provider business mailing address

278 QUEENS CREEK DR W
FRANKENMUTH MI
48734-1300
US

V. Phone/Fax

Practice location:
  • Phone: 989-770-0753
  • Fax:
Mailing address:
  • Phone: 989-770-0753
  • 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: AUBREY PETTYPLACE
Title or Position: OWNER
Credential: MA, BCBA, LBA
Phone: 989-770-0753