Individual
KYLIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
261 MACK AVE, DETROIT, MI 48201-2495
(313) 966-8309
Mailing address
261 MACK AVE, DETROIT, MI 48201-2495
(313) 966-8309
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5101012681
MI
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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