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Icecis Lenora Christine McCrimmon

Behavior Technician in Detroit, MI. Individual provider (NPI-1).

NPI number1619707536
StatusActive
Last updated in NPPESAug 5, 2024

Details

NPI
1619707536
Entity type
Individual (NPI-1)
Name
Ms. Icecis Lenora Christine McCrimmon
Sex
Female
Sole proprietor
No
Enumeration date
Aug 5, 2024
Certification date
Aug 5, 2024
Last updated
Aug 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician–MIYes

Practice location

400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1599

Phone 185-583-2672

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

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