Healthcare Provider Details

I. General information

NPI: 1801676747
Provider Name (Legal Business Name): MARLEY PRATER MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COUNTRY PINE LN
BATTLE CREEK MI
49015-4191
US

IV. Provider business mailing address

119 S 26TH ST
BATTLE CREEK MI
49015-2735
US

V. Phone/Fax

Practice location:
  • Phone: 800-653-4077
  • Fax:
Mailing address:
  • Phone: 269-719-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401003326
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: