| Doctor Name: | JORDAN PAUL BOUDREAU |
| NPI Number: | 1043567290 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS BCBA |
| License Number: | 1-09-5852 |
| Business Practice Address: | 990 Garfield Woods Dr Ste B Traverse City, MI - 496865160 |
| Business Phone Number: | 2314970555 |
| Business Fax Number: | |
| Mailing Address: | 990 Garfield Woods Dr Ste B, TRAVERSE CITY |
| State: | MI |
| Postal Code: | 496865160 |
| Phone Number: | 2314970555 |
| Fax Number: | |
| NPI Enumeration Date: | 08/07/2012 |
| NPI Last Update Date: | 03/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103K00000X |
| License Number: | 1-09-5852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Behavioral Analyst |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Behavior Analyst is a practitioner who specializes in analysis of behavior problems and development of appropriate intervention and treatment plans. A Behavior Analyst may work independently or with a team of professionals. Behavior Analysts often specialize in a particular area such as autism, developmental disabilities, mental health, geriatrics, or head trauma. |