Individual
AKISSI BONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30301 NORTHWESTERN HWY, FARMINGTON HILLS, MI 48334-3214
(248) 549-4339
Mailing address
30301 NORTHWESTERN HWY, FARMINGTON HILLS, MI 48334-3214
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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