Summer A Gilliam
Individual provider Active NPI Behavior Technician · Holt, MI
NPI 1003638552 · NPPES record last updated Oct 28, 2024
Key facts
- NPI
- 1003638552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4610 Spahr St
Holt, MI 48842-1124 - Phone
- (707) 495-2195
- NPI assigned
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | MI | Yes |
Addresses
Primary practice location
4610 Spahr St
Holt, MI 48842-1124
Mailing address
4015 Burkley Rd
Williamston, MI 48895-9409
Phone (517) 402-6901
Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.