Individual
JILL RENAE EMMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. BCBA
Contact information
Practice address
2323 E PARIS AVE SE STE 101, GRAND RAPIDS, MI 49546-2414
(616) 610-5697
Mailing address
2323 E PARIS AVE SE STE 101, GRAND RAPIDS, MI 49546-2414
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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