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NPI Code Detail

MEDICARE: TAYLOR MCKENZIE ARCHIBALD

MEDICARE: TAYLOR MCKENZIE ARCHIBALD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystMI

General Provider Information

NPI Number : 1023788015
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MCKENZIE ARCHIBALD
Provider Business Mailing Address
First Line : 5039 VILLA LINDE PKWY STE 30
Second Line :
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 989-401-2244
Fax Number :
Provider Business Practice Location Address
First Line : 3245 KEEWAHDIN RD
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-3498
Country : US
Telephone Number : 910-837-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2021
Last Update Date : 03/18/2026

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Directions to “ TAYLOR MCKENZIE ARCHIBALD ” Practice Location

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