Most Relevant Information
Provider Data
| NPI Number: | 1003585290 |
| Provider Name: | ERIC JAN KORSTANGE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/10/2021 |
| Last Updated: | 06/06/2023 |
Provider Practice Location
27777 INKSTER RD
FARMINGTON HILLS
MI
483345310
Practice Location Phone/Fax
| Phone: | 2482565020 |
| Fax: |
Provider Mailing Location
27777 INKSTER RD
FARMINGTON HILLS
MI
483345310
Provider Mailing Phone/Fax
| Phone: | 2482565020 |
| Fax: |