| Proud Moments Aba Of Michigan Pllc | |
|
25129 Pierce St Southfield MI 48075-2019 | |
| (718) 215-5311 | |
| Not Available |
| Full Name | Proud Moments Aba Of Michigan Pllc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 25129 Pierce St, Southfield, Michigan |
| Authorized Official Name and Position | Patty Buiocchi (COO) |
| Authorized Official Contact | 7182155311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proud Moments Aba Of Michigan Pllc 1449 37th St Ste 100 Brooklyn NY 11218-4381 Ph: (718) 215-5311 | Proud Moments Aba Of Michigan Pllc 25129 Pierce St Southfield MI 48075-2019 Ph: (718) 215-5311 |
| NPI Number | 1033726229 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033726229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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