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General NPI Number Information
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NPI Number | 1609227651
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Entity Type | Individual
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Provider Name | COURTNEY GREULICH
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Gender | Female
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 1695 W 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-2182
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Country | US
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Telephone | 248-691-8143
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Fax |
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Provider Business Mailing Address
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Address Line | 38935 ANN ARBOR RD STE 150
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City | LIVONIA
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State | MI
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Zip | 48150-3397
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Country | US
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Telephone | 248-886-9540
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Fax | 248-254-6613
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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 |
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License Number State |
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