Larry Kirby, BT

Individual provider Active NPI Behavior Technician · East Tawas, MI

NPI 1750003117 · NPPES record last updated Sep 13, 2022

Key facts

NPI
1750003117
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
111 Newman St
East Tawas, MI 48730-1272
Phone
(844) 854-1116
NPI assigned
Sep 13, 2022
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
Credentials
Bachelor of Theology

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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) 854-1116

Other providers in East Tawas, MI

All providers in East Tawas, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.