Individual
TIA JACQUELINE ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(124) 829-9003
Mailing address
4101 W ROSE CITY RD, WEST BRANCH, MI 48661-9428
(989) 254-8349
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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