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NPI Code Detail

MEDICARE: MOLLY SUZANNE PAVELEK

MEDICARE: MOLLY SUZANNE PAVELEK
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1023954641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY SUZANNE PAVELEK
Provider Business Mailing Address
First Line : 5225 STRICKER RD APT 101
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-9753
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10781 E CHERRY BEND RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-5249
Country : US
Telephone Number : 231-268-0007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 04/27/2026

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Directions to “ MOLLY SUZANNE PAVELEK ” Practice Location

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