Individual
LEX WAYNE BOTKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1617 E MILHAM AVE STE B, PORTAGE, MI 49002-3049
(269) 389-9102
Mailing address
1617 E MILHAM AVE STE B, PORTAGE, MI 49002-3049
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001541
IL
Other
Enumeration date
05/25/2018
Last updated
01/03/2025
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