Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-20-10814 | MI |
NPI | 1003347121 |
---|---|
Provider Name | Mr. Matthew Mueller |
First Address | Chesterfield, MI 48047-4585 |
Second Address | Chesterfield, MI 48047-4585 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2017 |
Last Update Date | 28/10/2020 |