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Organization
GATEWAY
Active
Organization
GATEWAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA CLEMENT (BEHAVIORAL TECHNICIAN)
(734) 796-6601
Entity
Organization
Contact information
Practice address
5840 N CANTON CENTER RD STE 270, CANTON, MI 48187-2614
(734) 796-6601
Mailing address
5840 N CANTON CENTER RD STE 270, CANTON, MI 48187-2614
(734) 796-6601
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
05/22/2024
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