Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301012566 | MI |
NPI | 1083797344 |
---|---|
Provider Name | Kimberly Ann Hiatt |
First Address | Kalamazoo, MI 49009-2196 |
Second Address | Kalamazoo, MI 49009-2196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 24/08/2017 |