Teresa Elizabeth Bowen

Individual provider Active NPI Behavior Technician · Fort Gratiot, MI

NPI 1104564491 · NPPES record last updated May 25, 2022

Key facts

NPI
1104564491
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3245 Keewahdin Rd
Fort Gratiot, MI 48059-3498
Phone
(810) 937-2345
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3245 Keewahdin Rd
Fort Gratiot, MI 48059-3498

Mailing address

5039 Villa Linde Pkwy Ste 30
Flint, MI 48532-3450
Phone (989) 401-2244

Other providers in Fort Gratiot, MI

All providers in Fort Gratiot, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.