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General NPI Number Information
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NPI Number | 1376452144
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Entity Type | Individual
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Provider Name | KELLY CARDOZO
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Gender | Female
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Dates
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Enumeration Date | 09/05/2026
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Last Update Date | 09/05/2026
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Provider Practice Location Address
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Address Line | 1340 E SQUARE LAKE RD
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City | TROY
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State | MI
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Zip | 48085-3326
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Country | US
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Telephone | 248-823-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 48429 LINDON CT
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-2632
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Country | US
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Telephone | 205-764-7721
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6801122266
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License Number State | MI
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