Peyton Goch

Individual provider Active NPI Behavior Technician · Jenison, MI

NPI 1740076017 · NPPES record last updated Apr 15, 2025

Key facts

NPI
1740076017
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
8413 Cottonwood Dr
Jenison, MI 49428-8327
Phone
(574) 387-4313
NPI assigned
Apr 15, 2025
Sex
Male
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

8413 Cottonwood Dr
Jenison, MI 49428-8327

Mailing address

215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (574) 387-4313

Other providers in Jenison, MI

All providers in Jenison, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.