Individual
REALITE LANICE PEEBLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA, BCBA
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247200000X
—
MI
Enumeration date
07/30/2019
Last updated
01/07/2026
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