Provider Demographics
NPI:1275319709
Name:WARD, ANDREA MORGAN (BCBA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MORGAN
Last Name:WARD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 CHESTER ARTHUR DR APT 302
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4964
Mailing Address - Country:US
Mailing Address - Phone:989-890-1475
Mailing Address - Fax:
Practice Address - Street 1:7030 WHITMORE LAKE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8533
Practice Address - Country:US
Practice Address - Phone:248-486-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-23-67039103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst