Individual
MRS. MICHELE RENEE HAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
14155 92 HWY, PLATTE CITY, MO 64079-8907
(816) 608-1500
Mailing address
20575 COUNTY ROAD DD, CAMDEN POINT, MO 64018-9193
(816) 304-6141
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2011004826
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2011004826
MO
Other
Enumeration date
03/18/2011
Last updated
02/21/2023
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