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NPI Code Detail

MEDICARE: ALEANA FITZGERALD MS, BCBA, LBA

MEDICARE: ALEANA FITZGERALD MS, BCBA, LBA
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
1103K00000XBehavior Analyst7401002807MI

General Provider Information

NPI Number : 1144784992
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEANA FITZGERALD MS, BCBA, LBA
Provider Business Mailing Address
First Line : 8413 COTTONWOOD DR
Second Line :
City : JENISON
State : MI
Zip : 49428-8327
Country : US
Telephone Number : 616-323-0082
Fax Number :
Provider Business Practice Location Address
First Line : 8413 COTTONWOOD DR
Second Line :
City : JENISON
State : MI
Zip : 49428-8327
Country : US
Telephone Number : 616-323-0082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2019
Last Update Date : 06/09/2025

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