Most Relevant Information
Provider Data
| NPI Number: | 1003326240 |
| Provider Name: | MARY BETH HALLORAN RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/02/2017 |
| Last Updated: | 10/02/2017 |
Provider Practice Location
1175 WESLEY AVE
MUSKEGON
MI
494422100
Practice Location Phone/Fax
| Phone: | 2312202344 |
| Fax: |
Provider Mailing Location
3080 MAPLE GROVE RD
MUSKEGON
MI
494414081
Provider Mailing Phone/Fax
| Phone: | 2317209277 |
| Fax: |