MEDICARE: TANYA VANILLO

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
1	103K00000X	Behavior Analyst	7401002605	MI

General Provider Information

NPI Number	:	1063821676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA VANILLO

Provider Business Mailing Address
First Line	:	223 BRIDGE ST APT C
Second Line	:
City	:	CHARLEVOIX
State	:	MI
Zip	:	49720-1400
Country	:	US
Telephone Number	:	562-209-1819
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 SPRING ST STE 4
Second Line	:
City	:	PETOSKEY
State	:	MI
Zip	:	49770-2881
Country	:	US
Telephone Number	:	231-268-0007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	02/09/2026

Similar Medicare Providers

1679425896 — AKIRA BRADSHAW
Practice Location Address:

910 SPRING ST STE 4
PETOSKEY, MI
49770-2881

Practice Phone: 810-339-5399
Practice Fax:

1710625934 — SYDNEY ELIZABETH DILLINGER-MEWBOURN
Practice Location Address:

910 SPRING ST STE 4
PETOSKEY, MI
49770-2881

Practice Phone: 231-268-0007
Practice Fax:

1285199281 — HANNAH SUE VANDENBOOM
Practice Location Address:

910 SPRING ST
PETOSKEY, MI
49770-2881

Practice Phone: 616-322-7358
Practice Fax:

1801465224 — KYRSEE TINGSTAD
Practice Location Address:

910 SPRING ST STE 4
PETOSKEY, MI
49770-2881

Practice Phone: 231-268-0007
Practice Fax:

1760188817 — ERYN TSCHUPP BCBA
Practice Location Address:

910 SPRING ST
PETOSKEY, MI
49770-2881

Practice Phone: 248-469-7769
Practice Fax:

1699468405 — DOMINIC ROBERT GREENOUGH
Practice Location Address:

910 SPRING ST STE 4
PETOSKEY, MI
49770-2881

Practice Phone: 231-268-0007
Practice Fax:

Directions to “ TANYA VANILLO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.