Healthcare Provider Details

I. General information

NPI: 1346124260
Provider Name (Legal Business Name): KELLY COOPER PARADIS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US

IV. Provider business mailing address

2300 SUN VALLEY DR
ANN ARBOR MI
48108-9699
US

V. Phone/Fax

Practice location:
  • Phone: 734-277-6651
  • Fax:
Mailing address:
  • Phone: 734-277-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: