Provider Demographics
NPI:1043692262
Name:PALMER, MICHAEL (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 WALNUT CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MI
Mailing Address - Zip Code:48880-1771
Mailing Address - Country:US
Mailing Address - Phone:989-817-1731
Mailing Address - Fax:
Practice Address - Street 1:214 WALNUT CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MI
Practice Address - Zip Code:48880-1771
Practice Address - Country:US
Practice Address - Phone:989-817-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst