Individual
KRISTA SKODACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA, LBA
Contact information
Practice address
6555 N WAYNE RD, WESTLAND, MI 48185-2713
(586) 243-0555
Mailing address
51145 NICOLETTE DR, CHESTERFIELD, MI 48047-4585
(586) 228-9991
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001650
MI
Other
Enumeration date
08/27/2021
Last updated
05/23/2022
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