Basic Information
| Provider Information | |||||||||
| NPI: | 1518174648 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AIMONE | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, LLP, BCBA, LBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 S RAISINVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481619754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7343840132 | ||||||||
| FaxNumber: | 7342435564 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 S RAISINVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481619754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342437340 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 6361006307 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | 103K00000X | 7401000422 | MI | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.