Provider Demographics
NPI:1508285271
Name:NG-A-FOOK, CASEY LYNN (MS BCBA)
Entity Type:Individual
Prefix:MS
First Name:CASEY
Middle Name:LYNN
Last Name:NG-A-FOOK
Suffix:
Gender:F
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 1:108 NORTH MAPLE ST.
Mailing Address - Street 2:#93
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176
Mailing Address - Country:US
Mailing Address - Phone:734-429-7938
Mailing Address - Fax:
Practice Address - Street 1:108 N MAPLE RD
Practice Address - Street 2:#93
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-7065
Practice Address - Country:US
Practice Address - Phone:734-429-7938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst