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NPI Code Detail

MEDICARE: REBECCA SMITH M.ED, BCBA

MEDICARE: REBECCA SMITH M.ED, BCBA
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 Analyst1-17-25276MI

General Provider Information

NPI Number : 1831504778
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA SMITH M.ED, BCBA
Provider Business Mailing Address
First Line : 44670 ANN ARBOR RD W STE 130
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-4085
Country : US
Telephone Number : 800-409-0096
Fax Number : 209-975-4142
Provider Business Practice Location Address
First Line : 44670 ANN ARBOR RD W STE 130
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-4085
Country : US
Telephone Number : 800-409-0096
Fax Number : 209-975-4142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2014
Last Update Date : 10/21/2025

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