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Organization
SPECTRUM AUTISM CENTER
Active
Organization
SPECTRUM AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEASA ANDROL MA, BCBA (CLINICAL DIRECTOR)
(989) 702-2082
Entity
Organization
Contact information
Practice address
3949 N RIVER RD, FREELAND, MI 48623-8856
(989) 702-2082
Mailing address
3949 N RIVER RD, FREELAND, MI 48623-8856
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
R130461067891
MI
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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