Most Relevant Information
Provider Data
NPI Number: | 1003559667 |
Provider Name: | KELLY ANN MORAN |
Entity Type: | Individual |
Taxonomy Code: | 106S00000X |
Specialty: | Behavior Technician |
License Number: |
Most Important Dates
Enumeration Date: | 04/20/2022 |
Last Updated: | 04/20/2022 |
Provider Practice Location
945 BARLOW ST
TRAVERSE CITY
MI
496864250
Practice Location Phone/Fax
Phone: | 2312680007 |
Fax: |
Provider Mailing Location
21151 WOODLAND TRL
ONAWAY
MI
497658817
Provider Mailing Phone/Fax
Phone: | |
Fax: |