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General NPI Number Information
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NPI Number | 1538968649
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Entity Type | Individual
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Provider Name | KRISTIN DALEY
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Gender |
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 2000 E OAKLEY PARK RD STE 101B
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City | COMMERCE TWP
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State | MI
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Zip | 48390-1500
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Country | US
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Telephone | 248-845-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 447 CAMERON AVE
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City | PONTIAC
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State | MI
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Zip | 48342-1809
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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