Individual
CHASE MICHAEL CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9616 PORTAGE RD, PORTAGE, MI 49002-7257
(269) 250-8200
Mailing address
1305 CONCORD PLACE DR APT 2D, KALAMAZOO, MI 49009-2225
(330) 440-2164
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB477883
OH
106S00000X
Behavior Technician
BACB477883
OH
Other
Enumeration date
01/04/2021
Last updated
10/10/2023
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