Individual
VICKIE LYNN KITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N WEST AVE, JACKSON, MI 49202-2179
(517) 789-1200
Mailing address
1200 N WEST AVE, JACKSON, MI 49202-2179
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
MA
175T00000X
Peer Specialist
Primary
—
MI
175T00000X
Peer Specialist
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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