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Search › Michigan › 164W00000X

Kelly Koustas

NPI 1528437597 · on the registry since 2015 · sole proprietor

Practice

Address
751 E Grand Blvd
Detroit, MI 48207
Phone
(313) 995-0523
Organisation at this address
Grand Pharmacy
Quality Behavioral Health
Quality Behavorial Health Inc.
Quality Behavioral Health, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
37

Registry record

Primary taxonomy
164W00000X
164W00000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-09-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan