Most Relevant Information
Provider Data
  | NPI Number: | 1003529041 | 
| Provider Name: | EDITH CERVANTES | 
| Entity Type: | Individual | 
| Taxonomy Code: | 106S00000X | 
| Specialty: | Behavior Technician | 
| License Number: | 
Most Important Dates
  | Enumeration Date: | 01/04/2023 | 
| Last Updated: | 01/05/2023 | 
Provider Practice Location
  1545 68TH ST SE STE 201
      
      KENTWOOD
      MI
      495087896
  Practice Location Phone/Fax
      | Phone: | 8447092049 | 
| Fax: | 
Provider Mailing Location
  1500 S DOUGLAS RD STE 230
      
      CORAL GABLES
      FL
      331344108
  Provider Mailing Phone/Fax
      | Phone: | |
| Fax: |