Provider Demographics
NPI:1528590148
Name:COMPO, DAKOTA CIERRA (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:DAKOTA
Middle Name:CIERRA
Last Name:COMPO
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:DAKOTA
Other - Middle Name:CIERRA
Other - Last Name:GUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA, LBA
Mailing Address - Street 1:16880 MIDDLEBELT RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3374
Mailing Address - Country:US
Mailing Address - Phone:734-371-7101
Mailing Address - Fax:
Practice Address - Street 1:16880 MIDDLEBELT RD STE 1
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3374
Practice Address - Country:US
Practice Address - Phone:734-371-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-02
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 106S00000X, 247200000X
MI1-19-34802103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other