Healthcare Provider Details

I. General information

NPI: 1104730027
Provider Name (Legal Business Name): SHAYLYN AUBREY OLGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 E CLARK RD STE 360-B
DEWITT MI
48820-7930
US

IV. Provider business mailing address

6105 S SAINT CLAIR RD
SAINT JOHNS MI
48879-9192
US

V. Phone/Fax

Practice location:
  • Phone: 517-507-5525
  • Fax:
Mailing address:
  • Phone: 517-643-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: