Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 6401009696 | MI |
Y | 103TC1900X | Counseling Psychologist | 6301013038 | MI |
NPI | 1083091037 |
---|---|
Provider Name | Karen Feaster |
First Address | Ada, MI 49301-9706 |
Second Address | Ada, MI 49301-9706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 29/04/2015 |