Healthcare Provider Details

I. General information

NPI: 1487234746
Provider Name (Legal Business Name): MICHELLE ANNE SCARBROUGH MA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE ANNE KEEDER MA

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 WILDER RD
BAY CITY MI
48706-2367
US

IV. Provider business mailing address

3727 WILDER RD
BAY CITY MI
48706-2367
US

V. Phone/Fax

Practice location:
  • Phone: 989-860-5176
  • Fax:
Mailing address:
  • Phone: 989-714-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133004262
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401002707
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: