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NPI Code Detail

MEDICARE: ANDREA WINEMILLER

MEDICARE: ANDREA WINEMILLER
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 : 1730721689
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA WINEMILLER
Provider Business Mailing Address
First Line : 2875 EYDE PKWY
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-5399
Country : US
Telephone Number : 616-301-8000
Fax Number :
Provider Business Practice Location Address
First Line : 2875 EYDE PKWY STE 100
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-5431
Country : US
Telephone Number : 616-301-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2019
Last Update Date : 05/11/2021

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Directions to “ ANDREA WINEMILLER ” Practice Location

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