Individual
ALYSSA CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13412 W STAR DR, SHELBY TOWNSHIP, MI 48315-2705
(586) 251-2556
Mailing address
13412 W STAR DR, SHELBY TOWNSHIP, MI 48315-2705
(586) 251-2556
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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