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NPI Code Detail

MEDICARE: AUTISM SYSTEMS LLC

MEDICARE: AUTISM SYSTEMS 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3103K00000XBehavior AnalystBA-79HI

General Provider Information

NPI Number : 1972030724
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTISM SYSTEMS LLC
Provider Business Mailing Address
First Line : 5039 VILLA LINDE PKWY STE 30
Second Line :
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 248-228-0502
Fax Number : 800-562-3347
Provider Business Practice Location Address
First Line : 3245 KEEWAHDIN RD
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3498
Country : US
Telephone Number : 989-401-2244
Fax Number : 800-562-3347
Authorized Official
Title or Position : OWNER
Name : MRS. RUCHI BHARDWAJ
Credential :
Telephone Number : 248-228-0502
Provider Enumeration Date : 05/11/2017
Last Update Date : 09/08/2022

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Directions to “AUTISM SYSTEMS LLC ” Practice Location

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