Tayla Leah Dulicai Wilson, RBT

Individual provider Active NPI Behavior Technician · Otsego, MI

NPI 1083391015 · NPPES record last updated Jul 13, 2023

Key facts

NPI
1083391015
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
115 W Allegan St
Otsego, MI 49078-1115
Phone
(231) 668-4909
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Behavior Technician 106S00000X MI Yes
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X

Addresses

Primary practice location

115 W Allegan St
Otsego, MI 49078-1115

Mailing address

1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 854-1116

Other providers in Otsego, MI

All providers in Otsego, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.