| Gateway | |
|
5840 N Canton Center Rd Ste 270 Canton MI 48187-2614 | |
| (734) 796-6601 | |
| Not Available |
| Full Name | Gateway |
|---|---|
| Speciality | Behavior Technician |
| Location | 5840 N Canton Center Rd Ste 270, Canton, Michigan |
| Authorized Official Name and Position | Christina Clement (BEHAVIORAL TECHNICIAN) |
| Authorized Official Contact | 7347966601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway 5840 N Canton Center Rd Ste 270 Canton MI 48187-2614 Ph: (734) 796-6601 | Gateway 5840 N Canton Center Rd Ste 270 Canton MI 48187-2614 Ph: (734) 796-6601 |
| NPI Number | 1003689035 |
|---|---|
| Provider Enumeration Date | 11/01/2023 |
| Last Update Date | 05/22/2024 |
| Certification Date | 05/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003689035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
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