Kelley B Gray II

Individual provider Active NPI Behavior Technician · Auburn, MI

NPI 1992279236 · NPPES record last updated Jan 21, 2019

Key facts

NPI
1992279236
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4600 Garfield Rd
Auburn, MI 48611-9369
Phone
(989) 266-3415
NPI assigned
Jan 21, 2019
Sex
Male
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 Yes

Addresses

Primary practice location

4600 Garfield Rd
Auburn, MI 48611-9369

Mailing address

4600 Garfield Rd
Auburn, MI 48611-9369
Phone (989) 266-3415

Other providers in Auburn, MI

All providers in Auburn, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.