Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YM0800X | Mental Health Counselor | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1215065446 |
---|---|
Provider Name | Kelly Infante |
First Address | Allen Park, MI 48101-5071 |
Second Address | Allen Park, MI 48101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 23/09/2019 |