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Individual

IRENE BANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. BCBA, LBA

Contact information

Practice address
932 N MITCHELL ST, CADILLAC, MI 49601-1285
(844) 854-1116
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 854-1116

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
MI
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P63034300169
DRIVER'S LICENSE
MI
Enumeration date
03/22/2019
Last updated
08/25/2023
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