Individual provider · NPI-1
Autumn Bouldin
Behavior Technician · Farmington Hills, MI
NPI number1790317675
StatusActive
Last updated in NPPESMay 16, 2023
Details
- NPI
- 1790317675
- Entity type
- Individual (NPI-1)
- Name
- Autumn Bouldin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 7, 2020
- Certification date
- May 16, 2023
- Last updated
- May 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
| 374U00000X | Home Health Aide | – | – | |
| 376K00000X | Nurse's Aide | – | – |
Practice location
27777 Inkster Rd Ste 100Farmington Hills, MI 48334-5312
Phone 248-436-4400
Mailing address
27777 Inkster Rd Ste 100Farmington Hills, MI 48334-5312
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