DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JESSICA KOELLING

MEDICARE: JESSICA KOELLING
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1164356200
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA KOELLING
Provider Business Mailing Address
First Line : 4234 CASCADE RD SE STE 3
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-8384
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4234 CASCADE RD SE STE 3
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-8384
Country : US
Telephone Number : 888-614-4144
Fax Number : 888-614-4144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

Similar Medicare Providers

1043144793 — REBECCA MARIE BURNS
Practice Location Address:
4234 CASCADE RD SE STE 3
GRAND RAPIDS, MI
49546-8384
Practice Phone: 888-614-4144
Practice Fax: 888-614-4144
1972432789 — JOHN PHILLIP WAKE
Practice Location Address:
4234 CASCADE RD SE STE 3
GRAND RAPIDS, MI
49546-8384
Practice Phone: 888-614-4144
Practice Fax:
1154256139 — SHELBI HARDENBURGH
Practice Location Address:
4234 CASCADE RD SE STE 3
GRAND RAPIDS, MI
49546-8384
Practice Phone: 888-614-4144
Practice Fax:
1407788821 — AMIAH JADE CLEMENTINE KROLL
Practice Location Address:
4234 CASCADE RD SE STE 3
GRAND RAPIDS, MI
49546-8384
Practice Phone: 888-614-4144
Practice Fax: 888-614-4144
1740112168 — SHARLENA IDRIS SHELTON
Practice Location Address:
4234 CASCADE RD SE STE 3
GRAND RAPIDS, MI
49546-8384
Practice Phone: 888-614-4144
Practice Fax:
1821920687 — AUDREY BELLE RATHJENS
Practice Location Address:
4234 CASCADE RD SE STE 3
GRAND RAPIDS, MI
49546-8384
Practice Phone: 888-614-4144
Practice Fax: 888-614-4144

Directions to “ JESSICA KOELLING ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.