Individual
MRS. HAILEY ELIZABETH GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
4234 CASCADE RD SE, GRAND RAPIDS, MI 49546-8384
(574) 904-9433
(844) 272-7692
Mailing address
4234 CASCADE RD SE, GRAND RAPIDS, MI 49546-8384
(574) 904-9433
(844) 272-7692
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-22-61107
FL
103K00000X
Behavior Analyst
Primary
7401003258
MI
106E00000X
Assistant Behavior Analyst
11307
FL
106S00000X
Behavior Technician
RBT-20-115122
FL
Other
Enumeration date
03/09/2020
Last updated
04/14/2026
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