Individual
STEFANIE THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. BCBA
Contact information
Practice address
43334 7 MILE RD STE 200, NORTHVILLE, MI 48167-2249
(844) 247-7222
Mailing address
43334 7 MILE RD STE 200, NORTHVILLE, MI 48167-2249
(844) 247-7222
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
M610777461858
MI
Other
Enumeration date
07/05/2016
Last updated
09/22/2023
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