=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033064191
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAYLOR LANAEE BROWN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1308 WOODRIDGE ST
-----------------------------------------------------
City | MUSKEGON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49442-4932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-614-4144
-----------------------------------------------------
Fax | 888-614-4144
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4234 CASCADE RD SE STE 3
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49546-8384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-614-4144
-----------------------------------------------------
Fax | 888-614-4144
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------