Provider Demographics
NPI:1790445849
Name:LAYTON, RACHEL BRIANNE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BRIANNE
Last Name:LAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 N DUNDALE RD
Mailing Address - Street 2:
Mailing Address - City:SPRUCE
Mailing Address - State:MI
Mailing Address - Zip Code:48762-9526
Mailing Address - Country:US
Mailing Address - Phone:989-657-4344
Mailing Address - Fax:
Practice Address - Street 1:111 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:EAST TAWAS
Practice Address - State:MI
Practice Address - Zip Code:48730-1272
Practice Address - Country:US
Practice Address - Phone:844-244-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician