Healthcare Provider Details

I. General information

NPI: 1336086529
Provider Name (Legal Business Name): ALESSA EVON BILLOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LENNON EVON BILLOT

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

6200 STATE ST
SAGINAW MI
48603-3490
US

IV. Provider business mailing address

5039 VILLA LINDE PKWY STE 30
FLINT MI
48532-3450
US

V. Phone/Fax

Practice location:
  • Phone: 989-401-2244
  • Fax:
Mailing address:
  • Phone: 989-401-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: