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Individual
MRS. DESHRA MICHELLE VINES
Active
Individual
MRS. DESHRA MICHELLE VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
BCBA1349277
MI
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS250263327
MI
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS2504124845
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9099470
DHS PROVIDER ID NUMBER
MI
Enumeration date
12/11/2008
Last updated
04/14/2026
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