Individual
HAILLE GENELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6296 BRIDGEPORT VILLAGE SQUARE DR STE 2, BRIDGEPORT, MI 48722-9655
(989) 401-1239
Mailing address
5039 VILLA LINDE PKWY STE 30, FLINT, MI 48532-3450
(989) 401-2244
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
MI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/09/2023
Last updated
03/24/2023
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