Individual
SARAH ROUGHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 RENAISSANCE CTR, DETROIT, MI 48243-1502
(855) 832-6727
(772) 675-9100
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33703
MI
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2472000000000000
—
MI
Enumeration date
05/18/2017
Last updated
01/22/2021
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