Individual
KELLIE VANASSCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
560 SYLVAN AVE STE 1110, ENGLEWOOD CLIFFS, NJ 07632-3118
(646) 873-6600
(646) 859-4440
Mailing address
15930 19 MILE RD, CLINTON TWP, MI 48038-1155
(586) 464-0175
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58779
MI
247200000X
Other Technician
—
—
Other
Enumeration date
08/31/2015
Last updated
03/22/2024
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