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General NPI Number Information
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NPI Number | 1114320355
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Entity Type | Organization
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Legal Business Name | NOVEL RESPONSES
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 8345 PLOVER DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-4514
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Country | US
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Telephone | 269-532-0193
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Fax |
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Provider Business Mailing Address
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Address Line | 2153 TWILIGHT PASS
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City | HOLT
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State | MI
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Zip | 48842-7708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | AMY MACFARLANE
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Credential |
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Telephone | 269-532-0193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-10134
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License Number State | MI
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