Provider Demographics
NPI:1467999417
Name:REUTER-YUILL, LILITH MICHAELE (PHD, CCC-SLP, BCBA)
Entity Type:Individual
Prefix:MS
First Name:LILITH
Middle Name:MICHAELE
Last Name:REUTER-YUILL
Suffix:
Gender:F
Credentials:PHD, CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 LOCUST ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5025
Mailing Address - Country:US
Mailing Address - Phone:618-201-2974
Mailing Address - Fax:
Practice Address - Street 1:1001 LAURENCE AVE STE E
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2980
Practice Address - Country:US
Practice Address - Phone:517-750-4777
Practice Address - Fax:517-782-4717
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146015814235Z00000X
MI7101006827235Z00000X
MI7401000638103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist