Individual
KAYLYNN AUDRA TECOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
20825 MACK AVE, GROSSE POINTE WOODS, MI 48236-1485
(313) 881-6900
Mailing address
20825 MACK AVE, GROSSE POINTE WOODS, MI 48236-1485
(313) 881-6900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101024602
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5101024602
STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
01
—
5315204737
STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
07/19/2016
Last updated
05/07/2025
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