Most Relevant Information
Provider Data
| NPI Number: | 1003652256 |
| Provider Name: | GACE ELIZABETH JEFFERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/08/2024 |
| Last Updated: | 07/08/2024 |
Provider Practice Location
4829 E BELTLINE AVE NE STE 310
GRAND RAPIDS
MI
495259350
Practice Location Phone/Fax
| Phone: | 6162796414 |
| Fax: |
Provider Mailing Location
4829 E BELTLINE AVE NE STE 310
GRAND RAPIDS
MI
495259350
Provider Mailing Phone/Fax
| Phone: | 6162796414 |
| Fax: |