Emma Deglopper
Individual provider Active NPI Behavior Technician · Jenison, MI
NPI 1962240671 · NPPES record last updated Jul 17, 2024
Key facts
- NPI
- 1962240671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 12148482 (MI)
- Practice address
- 8413 Cottonwood Dr
Jenison, MI 49428-8327 - Phone
- (574) 387-4313
- Fax
- (574) 204-2868
- NPI assigned
- Jul 17, 2024
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12148482 | MI | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vav Operations Mi, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 12148482 | MI | 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
- Elisabeth Dahl
- Daniel D Seitz DDS PC
- Nicholas Ruben Debernardi
- Kyler Ross Debruyn
- Brian J Decker
- Caitlyn Dehaan
- Joann Imelda Dehoek
- Kyle Dejong
- Roger Dejonge
- Susan Renee Deters
All providers in Jenison, 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 Jul 17, 2024. 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.