Individual
AMIYAH KYRAH DENISE BLACKSHEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23800 NORTHWESTERN HWY STE 190L, SOUTHFIELD, MI 48075-7740
(248) 900-2166
Mailing address
23800 NORTHWESTERN HWY STE 190L, SOUTHFIELD, MI 48075-7740
(248) 900-2166
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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