Healthcare Provider Details

I. General information

NPI: 1659298149
Provider Name (Legal Business Name): RAINA LILLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OASIS LILLARD

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S SAGINAW ST
FLINT MI
48503-3705
US

IV. Provider business mailing address

12315 ADAMS ST
MOUNT MORRIS MI
48458-3204
US

V. Phone/Fax

Practice location:
  • Phone: 810-257-3705
  • Fax: 810-257-3755
Mailing address:
  • Phone: 810-496-5553
  • Fax: 810-257-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: