Individual
ELYSE WISEMAN BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
400 RENAISSANCE CTR, SUITE 2600, DETROIT, MI 48243-1502
(855) 832-6727
(772) 675-9100
Mailing address
400 RENAISSANCE CTR, SUITE 2600, DETROIT, MI 48243-1502
(855) 832-6727
(772) 675-9100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1118442
MI
103K00000X
Behavior Analyst
6301014952
MI
Other
Enumeration date
10/19/2011
Last updated
01/07/2016
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