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General NPI Number Information
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NPI Number | 1275283301
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Entity Type | Organization
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Legal Business Name | NORTHWOODS LEARNING CENTER
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 1075 WOODWARD AVE LOWR LEVEL
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City | KINGSFORD
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State | MI
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Zip | 49802-4434
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Country | US
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Telephone | 906-828-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 703 E G ST
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-4131
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Country | US
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Telephone | 906-221-9608
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA THIEL
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Credential | BCBA
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Telephone | 906-828-2088
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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 |
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License Number State |
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