Provider Demographics
NPI:1720498157
Name:RAUPP, COURTNEY (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:RAUPP
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:CLARE
Other - Last Name:GRAMLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2221 LIVERNOIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1603
Mailing Address - Country:US
Mailing Address - Phone:248-544-0360
Mailing Address - Fax:248-544-0388
Practice Address - Street 1:2221 LIVERNOIS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1603
Practice Address - Country:US
Practice Address - Phone:248-544-0360
Practice Address - Fax:248-544-0388
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-13-13657103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst