Individual
SUL KWAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21600 NOVI RD STE 800, NOVI, MI 48375-5605
(248) 305-6193
Mailing address
21600 NOVI RD STE 800, NOVI, MI 48375-5605
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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