Individual
ASHLEY SOUTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 498-1685
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 498-1685
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
6301015435
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-13-13325
BCBA
—
01
—
7401000088
BEHAVIOR ANALYST LICENSE
MI
Enumeration date
03/01/2013
Last updated
03/18/2024
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