Jaquelle Reisner
Behavior Technician in Southfield, MI. Individual provider (NPI-1).
NPI number1184469736
StatusActive
Last updated in NPPESJun 26, 2024
Details
- NPI
- 1184469736
- Entity type
- Individual (NPI-1)
- Name
- Jaquelle Reisner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2024
- Certification date
- Jun 26, 2024
- Last updated
- Jun 26, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
29566 Northwestern Hwy Ste 100Southfield, MI 48034-1036
Phone 248-579-3119 · Fax 248-779-1819
Mailing address
29566 Northwestern Hwy Ste 100Southfield, MI 48034-1036
Phone 248-579-3119 · Fax 248-779-1819
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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