Kelly Gilliam

Individual provider Active NPI Behavior Technician · Pinckney, MI

NPI 1225565732 · NPPES record last updated May 8, 2018

Key facts

NPI
1225565732
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-17-43370
Practice address
9215 Anne St
Pinckney, MI 48169-8905
Phone
(734) 904-8265
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-43370 Yes

Addresses

Primary practice location

9215 Anne St
Pinckney, MI 48169-8905

Mailing address

9215 Anne St
Pinckney, MI 48169-8905
Phone (734) 904-8265

Other providers in Pinckney, MI

All providers in Pinckney, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.