Individual
MRS. LISA BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32100 TELEGRAPH RD STE 185, BINGHAM FARMS, MI 48025-2453
(248) 712-4266
Mailing address
32100 TELEGRAPH RD STE 185, BINGHAM FARMS, MI 48025-2453
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26744
MI
225800000X
Recreation Therapist
61754
MI
Other
Enumeration date
02/02/2017
Last updated
08/16/2017
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