Jeanessa Gant

Individual provider Active NPI Behavior Technician · Farmington Hills, MI

NPI 1447080171 · NPPES record last updated Sep 27, 2024

Key facts

NPI
1447080171
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-24-358046 (IN)
Practice address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone
(855) 772-8847
NPI assigned
Aug 6, 2024
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

State licenses

LicenseStateTypeSpecialty
RBT-24-358046INMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-358046 IN Yes

Addresses

Primary practice location

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312

Mailing address

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (855) 772-8847

Other providers in Farmington Hills, MI

All providers in Farmington Hills, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.