Individual
SARAH CLEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4234 CASCADE RD SE, GRAND RAPIDS, MI 49546-8384
(616) 942-5570
Mailing address
658 NORTHRUP AVE NW, GRAND RAPIDS, MI 49504-4704
(810) 358-3038
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-39698
MI
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548711658
—
MI
Enumeration date
10/24/2016
Last updated
04/18/2022
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