Organization
CANVAS ABA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA ANN BOUCHILLON MSPSY, BCBA, LBA (OWNER & CLINICAL DIRECTOR)
(810) 228-5248
Entity
Organization
Contact information
Practice address
3249 E WILSON RD, CLIO, MI 48420-9743
(810) 228-5248
Mailing address
PO BOX 118, CLIO, MI 48420-0118
(810) 228-5248
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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