Individual
LEAH BOUSAMRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
46200 PORT ST, PLYMOUTH, MI 48170-6048
(734) 454-0866
Mailing address
3507 RAYMOND AVE, DEARBORN, MI 48124-4281
(734) 645-9157
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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