MEDICARE: KAIRA GANDY

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1447704903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAIRA GANDY

Provider Business Mailing Address
First Line	:	8181 N WAYNE RD
Second Line	:	APT # 1068 G
City	:	WESTLAND
State	:	MI
Zip	:	48185-1328
Country	:	US
Telephone Number	:	248-259-8798
Fax Number	:

Provider Business Practice Location Address
First Line	:	8181 N WAYNE RD
Second Line	:	APT # 1068 G
City	:	WESTLAND
State	:	MI
Zip	:	48185-1328
Country	:	US
Telephone Number	:	248-259-8798
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2016
Last Update Date	:	08/12/2016

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Directions to “ KAIRA GANDY ” Practice Location

Language	Start Address	Practice Location

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