Individual
KAYLA ANTOINETTE GANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 STEVENS ST SW, GRAND RAPIDS, MI 49507-1526
(616) 469-3870
Mailing address
250 BURGUNDY SQ APT 104, EAST LANSING, MI 48823-2069
(313) 413-5000
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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