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NPI Code Detail

MEDICARE: SUZANNE TAYLOR

MEDICARE: SUZANNE TAYLOR
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 Analyst

General Provider Information

NPI Number : 1316339971
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE TAYLOR
Provider Business Mailing Address
First Line : 9981 BEND DR
Second Line :
City : JENISON
State : MI
Zip : 49428-9439
Country : US
Telephone Number : 616-818-8213
Fax Number :
Provider Business Practice Location Address
First Line : 120 STEVENS ST SW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-1526
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2015
Last Update Date : 08/10/2023

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Directions to “ SUZANNE TAYLOR ” Practice Location

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