Provider Demographics
NPI:1730957101
Name:STRAUGTER, AMBER Q'ANA
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:Q'ANA
Last Name:STRAUGTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51000 MOTT RD TRLR 103
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2119
Mailing Address - Country:US
Mailing Address - Phone:313-623-3481
Mailing Address - Fax:
Practice Address - Street 1:35360 NANKIN BLVD STE 802
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-7224
Practice Address - Country:US
Practice Address - Phone:248-876-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician