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NPI Code Detail

MEDICARE: WILLIAM LAVALLE

MEDICARE: WILLIAM LAVALLE
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

General Provider Information

NPI Number : 1740114313
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM LAVALLE
Provider Business Mailing Address
First Line : 2461 HOLLY HEIGHTS RD
Second Line :
City : HOLLY
State : MI
Zip : 48442-8335
Country : US
Telephone Number : 810-348-5928
Fax Number :
Provider Business Practice Location Address
First Line : 8401 HOLLY RD
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-1812
Country : US
Telephone Number : 810-691-5464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ WILLIAM LAVALLE ” Practice Location

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