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General NPI Number Information
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NPI Number | 1316733231
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Entity Type | Individual
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Provider Name | LENA PHILEMON
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Gender | Female
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 42 44TH ST SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-2177
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Country | US
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Telephone | 844-244-1818
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Fax |
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Provider Business Mailing Address
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Address Line | 2787 WILSON AVE NW
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City | WALKER
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State | MI
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Zip | 49534-7510
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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 |
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Name |
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Credential |
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Telephone |
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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 | 7401002892
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License Number State | MI
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