Individual
MRS. COURTNEY RENEE PENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243-1502
(855) 832-6727
Mailing address
1112 WAYCROFT CT, ROCHESTER, MI 48307-6043
(489) 784-6792
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46175
MI
106S00000X
Behavior Technician
RBT-18-65489
MI
Other
Enumeration date
09/25/2018
Last updated
09/27/2022
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