Healthcare Provider Details

I. General information

NPI: 1649778283
Provider Name (Legal Business Name): SHAYLA ANN WHITT M.ED., BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49970 VAN DYKE AVE # MI48317
SHELBY TOWNSHIP MI
48317-1347
US

IV. Provider business mailing address

49970 VAN DYKE AVE # MI48317
SHELBY TOWNSHIP MI
48317-1347
US

V. Phone/Fax

Practice location:
  • Phone: 586-991-6596
  • Fax: 248-712-4381
Mailing address:
  • Phone: 586-991-6596
  • Fax: 248-712-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: