Myra Elizabeth Granneman
Behavior Technician in Dearborn, MI. Individual provider (NPI-1).
NPI number1629969720
StatusActive
Last updated in NPPESJul 15, 2025
Details
- NPI
- 1629969720
- Entity type
- Individual (NPI-1)
- Name
- Myra Elizabeth Granneman
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 15, 2025
- Certification date
- Jul 15, 2025
- Last updated
- Jul 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
23663 Park StDearborn, MI 48124-2547
Phone 440-506-6742 · Fax 440-506-6742
Mailing address
23663 Park StDearborn, MI 48124-2547
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