| Great Lakes Behavior Analysis, Inc. | |
|
1575 Skyline Dr Cedarburg WI 53012-9397 | |
| (262) 385-5907 | |
| Not Available |
| Full Name | Great Lakes Behavior Analysis, Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1575 Skyline Dr, Cedarburg, Wisconsin |
| Authorized Official Name and Position | Danielle Deller (PRESIDENT/CEO) |
| Authorized Official Contact | 2623855907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Behavior Analysis, Inc. 1575 Skyline Dr Cedarburg WI 53012-9397 Ph: () - | Great Lakes Behavior Analysis, Inc. 1575 Skyline Dr Cedarburg WI 53012-9397 Ph: (262) 385-5907 |
| NPI Number | 1881049864 |
|---|---|
| Provider Enumeration Date | 04/27/2016 |
| Last Update Date | 04/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881049864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 28-140 (Wisconsin) | Primary |
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