Provider Demographics
NPI:1528398385
Name:MACFARLANE, AMY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:MACFARLANE
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 1:8345 PLOVER DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-4514
Mailing Address - Country:US
Mailing Address - Phone:269-353-4345
Mailing Address - Fax:269-353-4345
Practice Address - Street 1:8345 PLOVER DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-4514
Practice Address - Country:US
Practice Address - Phone:269-353-4345
Practice Address - Fax:269-353-4345
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-03-1082103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst