Individual
ELIZABETH THORNBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
120 STEVENS ST SW, GRAND RAPIDS, MI 49507-1526
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
7401001796
MI
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
247000000X
Health Information Technician
—
—
Other
Enumeration date
02/19/2019
Last updated
04/28/2022
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