Individual
KODIE HEADING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., BCBA, LBA
Contact information
Practice address
945 BARLOW ST, TRAVERSE CITY, MI 49686-4250
(231) 268-0007
Mailing address
8110 M 186, FIFE LAKE, MI 49633-9733
(231) 384-1308
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
07/16/2024
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