Organization
GIFTED AUTISM SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WHITE LBA, BCBA (BCBA/OWNER)
(616) 213-2965
Entity
Organization
Contact information
Practice address
4557 13 MILE RD NE, ROCKFORD, MI 49341-8623
(616) 213-2965
Mailing address
4557 13 MILE RD NE, ROCKFORD, MI 49341-8623
(616) 213-2965
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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