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Individual provider Active NPI Assistant Behavior Analyst · Grayling, MI
NPI 1922543073 · NPPES record last updated Dec 28, 2016
Key facts
- NPI
- 1922543073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Assistant Behavior Analyst 106E00000X
- Practice address
- 6720 Tomahawk TRL
Grayling, MI 49738 - Phone
- (989) 915-0764
- NPI assigned
- Dec 28, 2016
- 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 |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | Yes |
Addresses
Primary practice location
6720 Tomahawk TRL
Grayling, MI 49738
Mailing address
6720 Tomahawk TRL
Grayling, MI 49738-8921
Phone (989) 915-0764
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34991694 | Medicaid | MI |
Other providers in Grayling, MI
- Chloe Biggs
- Andrea Binert
- Tanya Birdsall
- Amanda G Blades
- Jason Bont
- Clayton Scott Brasseur
- Brookcare Hospice Services, LLC
- Andrew P Brookes
- Staci Jean Brown
- Romeo Cobcobo Buclay
All providers in Grayling, MI · Assistant Behavior Analyst in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2016. 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.