Individual
HEATHER MINICILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16700 17 MILE RD STE B, CLINTON TOWNSHIP, MI 48038-7325
(248) 894-8369
Mailing address
21600 NOVI RD STE 800, NOVI, MI 48375-5605
(248) 894-8369
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20098
MI
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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