Provider Demographics
NPI:1770822462
Name:NEWHOUSE-OISTEN, MINDY (PHD, BCBA-D, LLP)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:NEWHOUSE-OISTEN
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LLP
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:NEWHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:140 WEST MICHIGAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 WEST MICHIGAN AVENUE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017
Practice Address - Country:US
Practice Address - Phone:269-966-1460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016277103T00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist