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General NPI Number Information
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NPI Number | 1902606767
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Entity Type | Organization
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Legal Business Name | MICHIGAN ABA PROVIDERS INC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2751 E JEFFERSON AVE STE 400
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City | DETROIT
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State | MI
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Zip | 48207-4105
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Country | US
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Telephone | 231-289-1545
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 SHERIDAN ST STE 501
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3435
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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 | OFFICER
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Name | GITTY ENDZWEIG
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Credential |
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Telephone | 866-352-5010
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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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