Individual
MARISA HENRIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28000 WOODWARD AVE STE 100, ROYAL OAK, MI 48067-0961
(248) 395-3777
Mailing address
32100 TELEGRAPH RD STE 205, BINGHAM FARMS, MI 48025-2454
(248) 712-4266
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
01/13/2026
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