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Individual

KELLY BIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1910 SHAFFER ST, KALAMAZOO, MI 49048-1604
(269) 382-9820
Mailing address
1910 SHAFFER ST, KALAMAZOO, MI 49048-1604
(269) 382-9820

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L200465067833
DRIVERS LICENSE
MI
Enumeration date
08/23/2021
Last updated
08/23/2021
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