Emilia Grace Jefferson

Individual provider Active NPI Behavior Technician · China, MI

NPI 1154922771 · NPPES record last updated Nov 2, 2020

Key facts

NPI
1154922771
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3104 King Rd
China, MI 48054-1428
Phone
(810) 328-4500
NPI assigned
Nov 2, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Plus Healthcare Services LLC Past
since Nov 8, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3104 King Rd
China, MI 48054-1428

Mailing address

1912 Howard St
Port Huron, MI 48060-4914
Phone (810) 858-7483

Other providers in China, MI

All providers in China, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.