Provider Demographics
NPI:1093145583
Name:MACHALA, DAYNA (BCABA)
Entity Type:Individual
Prefix:MISS
First Name:DAYNA
Middle Name:
Last Name:MACHALA
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 THOMAS LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1575
Mailing Address - Country:US
Mailing Address - Phone:810-923-5372
Mailing Address - Fax:
Practice Address - Street 1:138 W HIGHLAND RD
Practice Address - Street 2:400-600
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2168
Practice Address - Country:US
Practice Address - Phone:517-376-4831
Practice Address - Fax:517-376-4833
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI0-16-7445106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other