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NPI Code Detail

MEDICARE: NORTHWOODS LEARNING CENTER

MEDICARE: NORTHWOODS LEARNING CENTER
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1275283301
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWOODS LEARNING CENTER
Provider Business Mailing Address
First Line : 703 E G ST
Second Line :
City : IRON MOUNTAIN
State : MI
Zip : 49801-4131
Country : US
Telephone Number : 906-221-9608
Fax Number :
Provider Business Practice Location Address
First Line : 1075 WOODWARD AVE LOWR LEVEL
Second Line :
City : KINGSFORD
State : MI
Zip : 49802-4434
Country : US
Telephone Number : 906-828-2088
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANGELA THIEL
Credential : BCBA
Telephone Number : 906-828-2088
Provider Enumeration Date : 03/23/2022
Last Update Date : 03/23/2022

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Directions to “NORTHWOODS LEARNING CENTER ” Practice Location

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