Individual
TANYA VANILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 SPRING ST STE 4, PETOSKEY, MI 49770-2881
(231) 268-0007
Mailing address
223 BRIDGE ST APT C, CHARLEVOIX, MI 49720-1400
(562) 209-1819
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16753
CA
103K00000X
Behavior Analyst
Primary
7401002605
MI
Other
Enumeration date
08/07/2014
Last updated
02/09/2026
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