Individual
TATEYANA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243
(855) 832-6727
Mailing address
23596 CLINTON ST BLDG 10, TAYLOR, MI 48180-4157
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/29/2020
Last updated
05/16/2021
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