Trista Lesage
Individual provider Active NPI Behavior Technician · East Tawas, MI
NPI 1487477303 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1487477303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 111 Newman St
East Tawas, MI 48730-1272 - Phone
- (844) 244-1818
- NPI assigned
- Nov 7, 2024
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
111 Newman St
East Tawas, MI 48730-1272
Mailing address
1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 244-1818
Other providers in East Tawas, MI
- Lisa Marie Lambert
- Camryn Landry
- Starr Dawn Lawrence
- Rachel Brianne Layton
- Haley Lesage
- Alyssa Ludwig
- Amanda Joann Lumsden
- Emily Macgregor
- Sofia Maj
- Grace Esther Male
All providers in East Tawas, MI · Behavior Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.