Individual
ANDREA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E PARIS AVE SE, GRAND RAPIDS, MI 49546-3691
(844) 854-1116
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 854-1116
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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