Gracia A Langeveld Blacketer, BEHAVIOR TECHNICIAN

NPI #1083482368 in Kentwood, Michigan

Provider Information

NPI Number: 1083482368
Entity Type: Individual
Name: Gracia A Langeveld Blacketer, BEHAVIOR TECHNICIAN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Credential: BEHAVIOR TECHNICIAN
Enumeration Date: Dec 15, 2023
Last Updated: Dec 15, 2023

Practice Location

Address: 1545 68TH ST SE STE 201
City: Kentwood
State: Michigan
ZIP Code: 49508-7896
Phone: (844) 244-1818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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