Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas Peter Theodore

Individual provider Behavior Technician · NPI 1912608407

Nicholas Peter Theodore is a Behavior Technician in Fort Gratiot, Michigan. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

3245 Keewahdin Rd
Fort Gratiot, MI 48059-3498
Phone: (810) 937-2345
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1912608407
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 13, 2023
Last updated in NPPESMarch 13, 2023
Certification dateMarch 13, 2023
Mailing address967 Ann St, Birmingham, MI 48009-1743

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