MEDICARE: JASILYN TEASLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1043174931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASILYN TEASLEY

Provider Business Mailing Address
First Line	:	50194 SCHOENHERR RD
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48315-3136
Country	:	US
Telephone Number	:	586-991-6596
Fax Number	:

Provider Business Practice Location Address
First Line	:	50194 SCHOENHERR RD
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48315-3136
Country	:	US
Telephone Number	:	586-991-6596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ JASILYN TEASLEY ” Practice Location

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