Provider Demographics
NPI:1831814763
Name:BRECHT, KAYLYNN
Entity type:Individual
Prefix:
First Name:KAYLYNN
Middle Name:
Last Name:BRECHT
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 1:11404 E GATES RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48877-9567
Mailing Address - Country:US
Mailing Address - Phone:989-388-7652
Mailing Address - Fax:
Practice Address - Street 1:118 W. SUPERIOR ST.
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801
Practice Address - Country:US
Practice Address - Phone:989-285-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other