NPI 1841765021 · live from the CMS NPI Registry
Soyaponga Providence Amisi
Behavior Analyst in Grand Rapids, MI. National Provider Identifier 1841765021, active.
NPI record
| NPI | 1841765021 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 2460 Burton St Se Ste 101, Grand Rapids, MI 49546 |
| Practice phone | 616-278-1201 |
| Mailing address | 5068 Rum Creek Ct Se, Kentwood, MI 49508 |
| Enumerated | October 3, 2018 |
| Last updated | October 3, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.