| Blue Bridge Aba Pllc | |
|
4370 Chicago Dr Sw Ste 304 Grandville MI 49418-1694 | |
| (248) 756-6009 | |
| Not Available |
| Full Name | Blue Bridge Aba Pllc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4370 Chicago Dr Sw Ste 304, Grandville, Michigan |
| Authorized Official Name and Position | Brianna Kuhatschek (BEHAVIOR ANALYST) |
| Authorized Official Contact | 2487566009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Bridge Aba Pllc 524 3 Mile Rd Ne Grand Rapids MI 49505-3345 Ph: (248) 756-6009 | Blue Bridge Aba Pllc 4370 Chicago Dr Sw Ste 304 Grandville MI 49418-1694 Ph: (248) 756-6009 |
| NPI Number | 1144971938 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 01/16/2022 |
| Certification Date | 01/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144971938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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