Provider Demographics
NPI:1700445228
Name:LOCKLEAR, BAYLEE RENEE (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:BAYLEE
Middle Name:RENEE
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:BAYLEE
Other - Middle Name:RENEE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 LEITH ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1612
Mailing Address - Country:US
Mailing Address - Phone:248-982-9416
Mailing Address - Fax:
Practice Address - Street 1:6894 W MAPLE RD FL 1
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3032
Practice Address - Country:US
Practice Address - Phone:833-455-8622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401002260103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst