Individual
MRS. TIFFANY KRISTEN KUBISIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
46200 PORT ST, PLYMOUTH, MI 48170-6048
(734) 454-0866
Mailing address
46200 PORT ST, PLYMOUTH, MI 48170-6048
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38446
MI
Other
Enumeration date
09/29/2019
Last updated
09/29/2019
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