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NPI Code Detail

MEDICARE: ARMEN IDRISS

MEDICARE: ARMEN IDRISS
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 : 1760119192
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARMEN IDRISS
Provider Business Mailing Address
First Line : 6915 ROTHBURY ST
Second Line :
City : PORTAGE
State : MI
Zip : 49024-3148
Country : US
Telephone Number : 269-503-1231
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 : 800-787-5118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2022
Last Update Date : 08/05/2022

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Directions to “ ARMEN IDRISS ” Practice Location

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