Provider Demographics
NPI:1851794051
Name:MILTON-HARRISON, MARIAH (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:MILTON-HARRISON
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 N OPDYKE RD STE D
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2694
Mailing Address - Country:US
Mailing Address - Phone:586-884-7052
Mailing Address - Fax:586-838-2472
Practice Address - Street 1:895 N OPDYKE RD STE D
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2694
Practice Address - Country:US
Practice Address - Phone:586-884-7052
Practice Address - Fax:586-838-2472
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11934462103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst