Healthcare Provider Details
I. General information
NPI: 1275473894
Provider Name (Legal Business Name): KENDRA GARDETTE-CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7007 DEXTER ANN ARBOR RD STE A
DEXTER MI
48130-8568
US
IV. Provider business mailing address
1336 RAMBLING RD
YPSILANTI MI
48198-3157
US
V. Phone/Fax
- Phone: 734-680-8800
- Fax:
- Phone: 734-678-6924
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: