Healthcare Provider Details

I. General information

NPI: 1285571430
Provider Name (Legal Business Name): MOLLY JANE BYLSMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

16760 LINCOLN ST
GRAND HAVEN MI
49417-8864
US

IV. Provider business mailing address

7523 WATERLINE DR
ALLENDALE MI
49401-9676
US

V. Phone/Fax

Practice location:
  • Phone: 616-317-2690
  • Fax: 616-226-5669
Mailing address:
  • Phone: 616-947-2421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: