Provider Demographics
NPI:1285454041
Name:PALLETT, KYLEE JEAN RENEE (KP)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:JEAN RENEE
Last Name:PALLETT
Suffix:
Gender:F
Credentials:KP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MI
Mailing Address - Zip Code:49093-2022
Mailing Address - Country:US
Mailing Address - Phone:269-535-9183
Mailing Address - Fax:
Practice Address - Street 1:306 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-2022
Practice Address - Country:US
Practice Address - Phone:269-535-9183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician