| Willow Behavior Specialists | |
|
2400 Niles Ave Saint Joseph MI 49085-1922 | |
| (262) 337-2292 | |
| Not Available |
| Full Name | Willow Behavior Specialists |
|---|---|
| Speciality | Assistant Behavior Analyst |
| Location | 2400 Niles Ave, Saint Joseph, Michigan |
| Authorized Official Name and Position | Lacy M Wolter (OWNER) |
| Authorized Official Contact | 2623372292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Behavior Specialists 2400 Niles Ave Saint Joseph MI 49085-1922 Ph: (262) 337-2292 | Willow Behavior Specialists 2400 Niles Ave Saint Joseph MI 49085-1922 Ph: (262) 337-2292 |
| NPI Number | 1356197487 |
|---|---|
| Provider Enumeration Date | 04/29/2024 |
| Last Update Date | 04/29/2024 |
| Certification Date | 04/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356197487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106E00000X | Assistant Behavior Analyst | (* (Not Available)) | Secondary |
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