Individual
KELLY M. KAIKKONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8245 HOLLY RD STE 200, GRAND BLANC, MI 48439-2483
(800) 693-1916
(248) 605-3525
Mailing address
PO BOX 772263, DETROIT, MI 48277-2263
(810) 441-0045
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401006044
MI
103TC0700X
Clinical Psychologist
6301009779
MI
Other
Enumeration date
10/04/2006
Last updated
08/17/2022
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