NPI 1003461070

Ivory Clinton

Practitioner Behavior Technician Warren, MI

Practice location

Address: 3601 E 11 Mile Rd, Warren, MI 48092-2878
Phone: (303) 989-8169

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1003461070
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Aug 2019
Record last updated: 7 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.