Carolyn Margaret Bourgois, MA/CNA/
Individual provider Active NPI Behavior Technician · Fort Gratiot, MI
NPI 1316520174 · NPPES record last updated Apr 29, 2021
Key facts
- NPI
- 1316520174
- 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
- Apr 29, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
- Karlene Bognar
- Jessica Bohm
- Emma Bonner
- Christopher J Borgiel
- Savannah Leigh Borgman
- Janeen Bourlier
- Julie A Boutt
- Teresa Elizabeth Bowen
- Steven W. Bremer
- Karen Brickner
All providers in Fort Gratiot, MI · Behavior Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.