Individual
ALISSE HELENE HAVLICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2814 WOODCLIFF CIR SE, GRAND RAPIDS, MI 49506-3155
(269) 449-1510
Mailing address
550 LYON ST NE APT 2, GRAND RAPIDS, MI 49503-3467
(269) 449-1510
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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