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NPI Code Detail

MEDICARE: KYRA CONNER

MEDICARE:   KYRA  CONNER
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
1106S00000XBehavior TechnicianMI

General Provider Information

NPI Number : 1932031069
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYRA CONNER
Provider Business Mailing Address
First Line : 18101 E WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48224-1382
Country : US
Telephone Number : 810-937-5012
Fax Number :
Provider Business Practice Location Address
First Line : 18101 E WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48224-1382
Country : US
Telephone Number : 810-937-5012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ KYRA CONNER ” Practice Location

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