Provider Demographics
NPI:1679051650
Name:GRABOWSKI, KAYLA (BCBA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:BOGGIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 412031
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2031
Mailing Address - Country:US
Mailing Address - Phone:194-294-4050
Mailing Address - Fax:
Practice Address - Street 1:12319 HIGHLAND RD STE 301
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2946
Practice Address - Country:US
Practice Address - Phone:810-991-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156F00000X
MI7401001578103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No156F00000XEye and Vision Services ProvidersTechnician/Technologist