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NPI Code Detail

MEDICARE: TEYONNA MARIE WOMACK

MEDICARE:   TEYONNA MARIE WOMACK
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 TechnicianMI

General Provider Information

NPI Number : 1780536953
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEYONNA MARIE WOMACK
Provider Business Mailing Address
First Line : 1321 S LINDEN RD STE B
Second Line :
City : FLINT
State : MI
Zip : 48532-3440
Country : US
Telephone Number : 248-221-2573
Fax Number :
Provider Business Practice Location Address
First Line : 1321 S LINDEN RD STE B
Second Line :
City : FLINT
State : MI
Zip : 48532-3440
Country : US
Telephone Number : 248-221-2573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 04/21/2026

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Directions to “ TEYONNA MARIE WOMACK ” Practice Location

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