Individual
MARK ZELLEFROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
15023 21 MILE RD, SHELBY TOWNSHIP, MI 48315-5024
(586) 286-9644
Mailing address
15023 21 MILE RD, SHELBY TOWNSHIP, MI 48315-5024
(586) 286-9644
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24832
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
Enumeration date
11/27/2013
Last updated
02/12/2019
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