MEDICARE: GUIDING GROWTH LLC

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1962225987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDING GROWTH LLC

Provider Business Mailing Address
First Line	:	26566 LAWRENCE DR
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-3380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26566 LAWRENCE DR
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-3380
Country	:	US
Telephone Number	:	313-854-5010
Fax Number	:

Authorized Official
Title or Position	:	BOARD CERTIFIED BEHAVIOR ANALYST
Name	:	LARA MERHI
Credential	:	M.S.
Telephone Number	:	313-854-5010

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	11/07/2024

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