Organization
ADVANCED AUTISM SERVICES MI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALKIE HERSKO MS CCC SLP (DIRECTOR)
(602) 584-9860
Entity
Organization
Contact information
Practice address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243-1502
(602) 584-9860
(602) 715-1135
Mailing address
211 BOULEVARD OF AMERICAS STE 402, LAKEWOOD, NJ 08701-4778
(602) 584-9860
(602) 715-1135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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