Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6362009107 | MI |
NPI | 1104431022 |
---|---|
Provider Name | Kaisey Foltz |
First Address | Plainwell, MI 49080-1768 |
Second Address | Plainwell, MI 49080-1768 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2020 |
Last Update Date | 14/10/2020 |