| Canvas Aba Pllc | |
|
3249 E Wilson Rd Clio MI 48420-9743 | |
| (810) 228-5248 | |
| Not Available |
| Full Name | Canvas Aba Pllc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3249 E Wilson Rd, Clio, Michigan |
| Authorized Official Name and Position | Natasha Ann Bouchillon (OWNER & CLINICAL DIRECTOR) |
| Authorized Official Contact | 8102285248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canvas Aba Pllc Po Box 118 Clio MI 48420-0118 Ph: (810) 228-5248 | Canvas Aba Pllc 3249 E Wilson Rd Clio MI 48420-9743 Ph: (810) 228-5248 |
| NPI Number | 1831899871 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 03/08/2023 |
| Certification Date | 03/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831899871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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