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Organization
CEAS
Active
Organization
CEAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY WESSELS (AUTHORIZED OFFICIAL)
(734) 545-6335
Entity
Organization
Contact information
Practice address
5877 LIVERNOIS RD, TROY, MI 48098-3100
(734) 545-6335
Mailing address
457 LINCOLN AVE, LINCOLN PARK, MI 48146-2815
(313) 932-2019
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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