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NPI Code Detail

MEDICARE: LEYLA GRACE AKI

MEDICARE: LEYLA GRACE AKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1073033627
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEYLA GRACE AKI
Provider Business Mailing Address
First Line : 955 CAMPUS DR N
Second Line :
City : WATERFORD
State : MI
Zip : 48328-2754
Country : US
Telephone Number : 248-475-6300
Fax Number : 248-475-6402
Provider Business Practice Location Address
First Line : 955 CAMPUS DR N
Second Line :
City : WATERFORD
State : MI
Zip : 48328-2754
Country : US
Telephone Number : 248-451-2940
Fax Number : 248-475-6403
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2017
Last Update Date : 06/25/2017

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Directions to “ LEYLA GRACE AKI ” Practice Location

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