Individual
JEREMY ZACK GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, BCBA, LBA
Contact information
Practice address
3513 MIAMI AVE, KALAMAZOO, MI 49048-7318
(248) 514-6757
Mailing address
3513 MIAMI AVE, KALAMAZOO, MI 49048-7318
(248) 514-6757
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401000731
MI
Other
Enumeration date
04/19/2016
Last updated
12/03/2021
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