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NPI Code Detail

MEDICARE: JANAE MUSSELMAN

MEDICARE: JANAE MUSSELMAN
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 Analyst0-14-6124
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1396131330
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANAE MUSSELMAN
Provider Business Mailing Address
First Line : PO BOX 663
Second Line :
City : LAKELAND
State : MI
Zip : 48143-0663
Country : US
Telephone Number : 810-599-2129
Fax Number :
Provider Business Practice Location Address
First Line : 300 SAINT ANDREWS RD STE 407
Second Line :
City : SAGINAW
State : MI
Zip : 48638-5977
Country : US
Telephone Number : 989-401-9020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2015
Last Update Date : 04/10/2023

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Directions to “ JANAE MUSSELMAN ” Practice Location

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