Individual
DR. KELLY KOHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, BCBA-D
Contact information
Practice address
23200 RED ARROW HWY, MATTAWAN, MI 49071-7774
(269) 355-6621
Mailing address
23200 RED ARROW HWY, MATTAWAN, MI 49071-7774
(269) 355-6621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-10-7746
1-10-7746
MI
01
—
7401000234
BEHAVIOR ANALYST LICENSE
MI
Enumeration date
04/12/2016
Last updated
07/12/2022
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