Healthcare Provider Details

I. General information

NPI: 1528972528
Provider Name (Legal Business Name): KAYLYNN DIANE BAILER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

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

27550 SCHOENHERR RD STE 250
WARREN MI
48088-6678
US

IV. Provider business mailing address

23821 BUNKERHILL DR
CLINTON TOWNSHIP MI
48035-3119
US

V. Phone/Fax

Practice location:
  • Phone: 989-401-2244
  • Fax:
Mailing address:
  • Phone: 586-298-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: