Provider Demographics
NPI:1619410230
Name:KLEPPER, KECIA
Entity Type:Individual
Prefix:
First Name:KECIA
Middle Name:
Last Name:KLEPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22601 ALLEN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2273
Mailing Address - Country:US
Mailing Address - Phone:734-752-4353
Mailing Address - Fax:
Practice Address - Street 1:22601 ALLEN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-2273
Practice Address - Country:US
Practice Address - Phone:734-752-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501004516237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist