Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | - | MI |
NPI | 1053073031 |
---|---|
Provider Name | Michaela Sexton |
First Address | Grosse Ile, MI 48138-1276 |
Second Address | Kentwood, MI 49508-7896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2021 |
Last Update Date | 07/10/2021 |