Provider Demographics
NPI:1710341755
Name:SCHENK, YANNICK ANDREW (MA, BCBA)
Entity Type:Individual
Prefix:MR
First Name:YANNICK
Middle Name:ANDREW
Last Name:SCHENK
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DAVIS ST APT 4
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5090
Mailing Address - Country:US
Mailing Address - Phone:231-670-9448
Mailing Address - Fax:
Practice Address - Street 1:415 DAVIS ST APT 4
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5090
Practice Address - Country:US
Practice Address - Phone:231-670-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-15-18939103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst