Active NPI
Porscha Wilson
- Assistant Behavior Analyst
- Saginaw, MI
National Provider Identifier
1366958472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 7402000187
- Practice address
- 5451 Hampton PL
Saginaw, MI 48604-9284 - Phone
- (989) 412-4410
- NPI assigned
- Dec 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 7402000187 | MI | Primary |
Addresses
Primary practice location
5451 Hampton PL
Saginaw, MI 48604-9284
Mailing address
5451 Hampton PL
Saginaw, MI 48604-9284
Phone (989) 412-4410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7402000187 | MI | MD | Assistant Behavior Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1366958472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5451 HAMPTON PL",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486049284",
"telephone_number": "989-412-4410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5451 HAMPTON PL",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486049284",
"telephone_number": "989-412-4410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "PORSCHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-27",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "MI",
"license": "7402000187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.