Individual
HARLEY RENEE MASUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33464 SCHOENHERR RD, STERLING HEIGHTS, MI 48312-6314
(586) 275-2478
Mailing address
20500 STAFFORD ST, CLINTON TOWNSHIP, MI 48035-4067
(586) 563-5234
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/28/2021
Last updated
10/14/2022
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