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NPI Code Detail

MEDICARE: TAYLOR RAAYMAKERS

MEDICARE: TAYLOR RAAYMAKERS
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 Analyst2022-113AL
2106S00000XBehavior Technician
3103K00000XBehavior Analyst7401002216MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538640644
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR RAAYMAKERS
Provider Business Mailing Address
First Line : 3409 FAWN COVE LN APT 3
Second Line :
City : PORTAGE
State : MI
Zip : 49024-4776
Country : US
Telephone Number : 616-826-6258
Fax Number :
Provider Business Practice Location Address
First Line : 3769 QUARTON RD
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48302-4058
Country : US
Telephone Number : 248-894-1966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2018
Last Update Date : 07/01/2024

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1912510033 — DEMETRIUS BURKE QIDP,
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1265219166 — COLTON HARDER BS
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Directions to “ TAYLOR RAAYMAKERS ” Practice Location

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