Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 5201010025 | MI |
NPI | 1437663721 |
---|---|
Provider Name | Kaitlyn Patton |
First Address | Saginaw, MI 48602-3106 |
Second Address | Saginaw, MI 48602-3106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2017 |
Last Update Date | 22/11/2017 |