Kayla Marie Datema
Individual provider Active NPI Behavior Technician · Stanton, MI
NPI 1609410992 · NPPES record last updated Oct 30, 2019
Key facts
- NPI
- 1609410992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 100 E Main St Ste a
Stanton, MI 48888-8601 - Phone
- (989) 372-9550
- NPI assigned
- Oct 30, 2019
- 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
100 E Main St Ste a
Stanton, MI 48888-8601
Mailing address
21600 Oxnard St
Woodland Hills, CA 91367-4976
Phone (818) 345-2345
Other providers in Stanton, MI
- Countryside Drug Company I
- County of Montcalm
- John Stewart Couture
- Penny Jean Crawford
- Michell M Curtis
- Michelle Frances Davis-Vanarnam
- Shailyn Gayle Davis
- Jacob Henry Day
- Madalyn Jane Deason
- John Debiak
All providers in Stanton, 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 Oct 30, 2019. 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.