Individual
MRS. LAUREN MARIE TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
1 HERITAGE DR STE 100, SOUTHGATE, MI 48195-3047
(734) 767-2250
Mailing address
1 HERITAGE DR STE 100, SOUTHGATE, MI 48195-3047
(734) 767-2250
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001585
MI
247200000X
Other Technician
—
—
Other
Enumeration date
07/23/2014
Last updated
10/17/2023
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