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NPI 1518670751

NPI 1518670751 : SAVANNAH NICOLE CRESSMAN : MUSKEGON, MI

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General NPI Number Information
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    NPI Number           |    1518670751
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    Entity Type          |    Individual 
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    Provider Name        |    SAVANNAH NICOLE CRESSMAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/03/2023
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    Last Update Date     |    01/03/2023
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Provider Practice Location Address
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    Address Line         |    1910 E APPLE AVE STE F 
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    City                 |    MUSKEGON
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    State                |    MI
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    Zip                  |    49442-4281
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    Country              |    US
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    Telephone            |    231-354-2588
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2386 EWING RD 
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    City                 |    TWIN LAKE
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    State                |    MI
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    Zip                  |    49457-9750
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    Country              |    US
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    Telephone            |    231-736-2940
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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