Dziedzic, Kelly

Dziedzic, Kelly is an sole proprietor health care provider with primary practice located at 8397 Fawn Meadow Trl , Galesburg MI 49053-7745. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Dziedzic, Kelly can be contacted via phone (269) 760-0660.

Contact Information

Primary practice address
8397 Fawn Meadow Trl Galesburg MI 49053-7745
Phone: (269) 760-0660
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6361004240 Michigan
Behavioral Health & Social Service Providers / Counseling 103TC1900X 6361004240 Michigan

Profile Details

NPI number 1821255423
LBN Legal business name Dziedzic, Kelly
Credentials LLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2008
Last updated Mar 31st, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821255423 NPPES
Michigan MEDICAID 1708146

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