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Individual

KELSEY ORION HYDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
46200 PORT ST, PLYMOUTH, MI 48170-6048
(734) 454-0866
Mailing address
46200 PORT ST, PLYMOUTH, MI 48170-6048
(734) 454-0866

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7152000071
MI

Other

Enumeration date
06/02/2021
Last updated
06/02/2021
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