Isabella Puckett

Individual provider Active NPI Behavior Analyst · Bear Lake, MI

NPI 1124806500 · NPPES record last updated Sep 18, 2023

Key facts

NPI
1124806500
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
11660 Chippewa Hwy
Bear Lake, MI 49614-9419
Phone
(231) 655-3146
NPI assigned
Sep 18, 2023
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)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

11660 Chippewa Hwy
Bear Lake, MI 49614-9419

Mailing address

11660 Chippewa Hwy
Bear Lake, MI 49614-9419
Phone (231) 655-3146

Other providers in Bear Lake, MI

All providers in Bear Lake, MI · Behavior Analyst in Michigan

Sources for this page

Verify at the official NPI Registry.