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General NPI Number Information
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NPI Number | 1053073031
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Entity Type | Individual
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Provider Name | MICHAELA SEXTON
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Gender | Female
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 42 44TH ST SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-2177
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Country | US
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Telephone | 231-668-4909
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Fax |
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Provider Business Mailing Address
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Address Line | 9435 WHITALL LN
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City | GROSSE ILE
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State | MI
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Zip | 48138-1276
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Country | US
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Telephone | 734-752-5228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | -
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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