Most Relevant Information
Provider Data
| NPI Number: | 1003503723 |
| Provider Name: | EDDIE RAY KNUCKLES |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/21/2023 |
| Last Updated: | 04/21/2023 |
Provider Practice Location
17650 E 9 MILE RD
EASTPOINTE
MI
480212564
Practice Location Phone/Fax
| Phone: | 5862188570 |
| Fax: |
Provider Mailing Location
17650 E 9 MILE RD
EASTPOINTE
MI
480212564
Provider Mailing Phone/Fax
| Phone: | 5862188570 |
| Fax: |