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: |