Kaitlyn Rose Blackmer

Individual provider Active NPI Behavior Technician · Essexville, MI

NPI 1508633017 · NPPES record last updated Dec 5, 2023

Key facts

NPI
1508633017
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
955 N Pine Rd
Essexville, MI 48732-2109
Phone
(989) 702-2082
NPI assigned
Dec 5, 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 Technician 106S00000X Yes

Addresses

Primary practice location

955 N Pine Rd
Essexville, MI 48732-2109

Mailing address

955 N Pine Rd
Essexville, MI 48732-2109
Phone (989) 702-2082

Other providers in Essexville, MI

All providers in Essexville, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.