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Individual

ALEXANDER KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Mailing address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
04/05/2024
Last updated
04/05/2024
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