Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 5201002441 | MI |
NPI | 1487892402 |
---|---|
Provider Name | James E Palkowski |
First Address | Scotts, MI 49088-9742 |
Second Address | Kalamazoo, MI 49008-1205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2009 |
Last Update Date | 17/02/2009 |