(800) 868-1923

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: