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NPI Code Detail

MEDICARE: NICOLE SUSAN BARONE RBT

MEDICARE: NICOLE SUSAN BARONE RBT
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 : 1477210995
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE SUSAN BARONE RBT
Provider Business Mailing Address
First Line : 10327 GRAND RIVER RD STE 401
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-6501
Country : US
Telephone Number : 734-323-0502
Fax Number :
Provider Business Practice Location Address
First Line : 10327 GRAND RIVER RD STE 401
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-6501
Country : US
Telephone Number : 734-323-0502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2021
Last Update Date : 11/18/2021

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Directions to “ NICOLE SUSAN BARONE RBT” Practice Location

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