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NPI Code Detail

MEDICARE: CANDACE A CUMMINGS

MEDICARE: CANDACE A CUMMINGS
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
2156F00000XTechnician/Technologist

General Provider Information

NPI Number : 1144719063
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE A CUMMINGS
Provider Business Mailing Address
First Line : 1 HERITAGE DR STE 100
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-3047
Country : US
Telephone Number : 248-221-2399
Fax Number :
Provider Business Practice Location Address
First Line : 1 HERITAGE DR STE 100
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-3047
Country : US
Telephone Number : 248-221-2399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2018
Last Update Date : 01/10/2022

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1760890735 — MRS. LAUREN MARIE TYLER MA, BCBA
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Directions to “ CANDACE A CUMMINGS ” Practice Location

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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.

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