Individual
KYLEIGH FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
(616) 281-6459
Mailing address
4829 E BELTLINE AVE NE STE 310, GRAND RAPIDS, MI 49525-9350
(616) 279-6414
(616) 591-3393
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
12/12/2025
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