Organization
WILLOW BEHAVIOR SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LACY M WOLTER BCBA, LBA (OWNER)
(262) 337-2292
Entity
Organization
Contact information
Practice address
2400 NILES AVE, SAINT JOSEPH, MI 49085-1922
(262) 337-2292
Mailing address
2400 NILES AVE, SAINT JOSEPH, MI 49085-1922
(262) 337-2292
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
09/11/2025
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