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General NPI Number Information
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NPI Number | 1639091366
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Entity Type | Individual
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Provider Name | JESSICA LEE GARRITY RBT
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Gender | Female
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 12319 HIGHLAND RD STE 301
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City | HARTLAND
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State | MI
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Zip | 48353-2946
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Country | US
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Telephone | 248-714-8445
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Fax | 248-918-2880
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Provider Business Mailing Address
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Address Line | 3515 EMERALD PARK DR
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City | MILFORD
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State | MI
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Zip | 48380-3358
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Country | US
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Telephone | 586-201-4593
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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 | G630403497635
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License Number State | MI
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