Individual
KYLAYHA D JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4036 BENNETT LAKE RD APT SUITE, FENTON, MI 48430-8709
(810) 877-5919
Mailing address
17940 FARMINGTON RD STE 302, LIVONIA, MI 48152-3159
(810) 877-5919
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009617
MI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/15/2021
Last updated
05/30/2025
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