Ivory Mamo

NPI #1447975685 in Waterford, Michigan

Provider Information

NPI Number: 1447975685
Entity Type: Individual
Name: Ivory Mamo
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 10, 2022
Last Updated: Oct 10, 2022

Practice Location

Address: 955 CAMPUS DR N
City: Waterford
State: Michigan
ZIP Code: 48328-2754
Phone: (248) 475-6300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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