Zellefrow, Mark

Zellefrow, Mark is an individual health care provider with primary practice located at 15023 21 Mile Rd , Shelby Township MI 48315-5024. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is his primary health care specialty. Zellefrow, Mark can be contacted via phone (586) 286-9644.

Contact Information

Primary practice address
15023 21 Mile Rd Shelby Township MI 48315-5024
Phone: (586) 286-9644
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-16-24832

Profile Details

NPI number 1093145120
LBN Legal business name Zellefrow, Mark
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2013
Last updated Feb 12th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093145120 NPPES
Ohio MEDICAID 2846675

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