Individual
KYLE JAY MOKMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
6654 ANDALE AVE SW, GRAND RAPIDS, MI 49548-6745
(231) 390-5207
Mailing address
6654 ANDALE AVE SW, GRAND RAPIDS, MI 49548-6745
(231) 390-5207
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-53120
CO
Other
Enumeration date
12/30/2021
Last updated
05/16/2023
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