Individual
ALISON WIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
526 W CENTRE AVE, PORTAGE, MI 49024-5306
(269) 321-9556
Mailing address
526 W CENTRE AVE, PORTAGE, MI 49024-5306
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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