Organization
EASTERN MICHIGAN UNIVERSITY
Active
Other names
Autism Collaborative Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINE LYNN KASTLE-RUETHER (MANAGING DIRECTOR)
(734) 487-2890
Entity
Organization
Contact information
Practice address
1055 CORNELL RD, FLETCHER BUILDING,, YPSILANTI, MI 48197-1657
(734) 485-2890
Mailing address
1055 CORNELL RD, FLETCHER BUILDING, ACC MAIN OFFICE, YPSILANTI, MI 48197-1657
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1780989020
MI
174400000X
Specialist
1699070656
MI
174400000X
Specialist
23317193
MI
174400000X
Specialist
Primary
5201007984
MI
235Z00000X
Speech-Language Pathologist
1215113246
MI
Other
Enumeration date
12/08/2011
Last updated
01/15/2019
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