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NPI Code Detail

MEDICARE: KAYLEA ANN PROKSCH M.S., BCBA

MEDICARE: KAYLEA ANN PROKSCH M.S., BCBA
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 Analyst430140WI
2103K00000XBehavior Analyst7401001884MI

General Provider Information

NPI Number : 1194399550
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEA ANN PROKSCH M.S., BCBA
Provider Business Mailing Address
First Line : 2353 BADGER STREET
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-2303
Country : US
Telephone Number : 906-273-1121
Fax Number : 906-225-6706
Provider Business Practice Location Address
First Line : 2353 BADGER STREET
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-2303
Country : US
Telephone Number : 906-273-1121
Fax Number : 906-225-6706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2021
Last Update Date : 02/09/2026

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