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NPI Code Detail

MEDICARE: KAITLYN DENDRINOS

MEDICARE: KAITLYN DENDRINOS
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 Analyst1-14-16112MI

General Provider Information

NPI Number : 1235539248
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN DENDRINOS
Provider Business Mailing Address
First Line : 14680 NEWBURGH RD
Second Line :
City : LIVONIA
State : MI
Zip : 48154-5034
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14680 NEWBURGH RD
Second Line :
City : LIVONIA
State : MI
Zip : 48154-5034
Country : US
Telephone Number : 616-942-2522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2014
Last Update Date : 01/15/2021

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Directions to “ KAITLYN DENDRINOS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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