NPI 1942910773 · live from the CMS NPI Registry
Jill Agents
Behavior Analyst in Grand Rapids, MI. National Provider Identifier 1942910773, active.
NPI record
| NPI | 1942910773 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 3809 Lake Eastbrook Blvd Se, Grand Rapids, MI 49546 |
| Practice phone | 616-604-8493 |
| Enumerated | December 2, 2022 |
| Last updated | June 24, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Technician | 106S00000X | — |
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.