Individual
STUART SEGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1415 WEALTHY ST SE APT 312, GRAND RAPIDS, MI 49506
(586) 436-3690
Mailing address
1415 WEALTHY ST SE APT 312, GRAND RAPIDS, MI 49506-2804
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
6401015426
MI
Other
Enumeration date
09/10/2015
Last updated
09/04/2018
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