Jordan Kotwicki
Behavior Technician in Kentwood, MI. Individual provider (NPI-1).
NPI number1982116687
StatusActive
Last updated in NPPESNov 2, 2017
Details
- NPI
- 1982116687
- Entity type
- Individual (NPI-1)
- Name
- Jordan Kotwicki
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2017
- Last updated
- Nov 2, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | K320439564172 | MI | Yes |
Practice location
5366 Eastern Ave SeKentwood, MI 49508-6018
Phone 616-608-3665
Mailing address
4477 Lake Michigan Dr Apt B3Allendale, MI 49401-9104
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