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NPI Code Detail

MEDICARE: KELSEY PALERMO-RE

MEDICARE: KELSEY PALERMO-RE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1871135228
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY PALERMO-RE
Provider Business Mailing Address
First Line : 10327 GRAND RIVER RD STE 401
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-6501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10327 GRAND RIVER RD STE 401
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-6501
Country : US
Telephone Number : 917-946-5456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2019
Last Update Date : 10/16/2019

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Directions to “ KELSEY PALERMO-RE ” Practice Location

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