Individual
KERBY KEYLON KILLINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 WIDDICOMB AVE NW, GRAND RAPIDS, MI 49504-3048
(616) 856-0037
Mailing address
1939 S DIVISION AVE, GRAND RAPIDS, MI 49507
(616) 247-3815
(616) 245-0450
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401017677
MI
Other
Enumeration date
10/24/2017
Last updated
01/14/2020
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