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Individual

AMBER FAGERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
30000 HIVELEY ST, INKSTER, MI 48141-1089
(734) 728-3400
Mailing address
716 DAVENPORT DR, DUNDEE, MI 48131-9402
(734) 634-1420

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
10/19/2016
Last updated
10/19/2016
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