Organization
MODERN AUTISM GROUP, LLC
Active
Other names
ModernAutism.com
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALEN HANNA (MEMBER)
(248) 805-1474
Entity
Organization
Contact information
Practice address
3250 W BIG BEAVER RD STE 312-A, TROY, MI 48084-2900
(248) 805-1474
Mailing address
3250 W BIG BEAVER RD STE 312-A, TROY, MI 48084-2900
(248) 805-1474
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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