Taylor Rose Kelly

Individual provider Active NPI Behavior Technician · Freeland, MI

NPI 1487324968 · NPPES record last updated Sep 16, 2021

Key facts

NPI
1487324968
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3949 N River Rd
Freeland, MI 48623-8856
Phone
(989) 702-2082
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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
Spectrum Autism Center Behavior Technician Past
since Sep 23, 2021
Accepting new patients
Spectrum Autism Center LLC Past
since Sep 23, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3949 N River Rd
Freeland, MI 48623-8856

Mailing address

3949 N River Rd
Freeland, MI 48623-8856
Phone (989) 702-2082

Other providers in Freeland, MI

All providers in Freeland, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.