Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301010132 | MI |
NPI | 1043368178 |
---|---|
Provider Name | Mrs. Kimberly L. Lem |
First Address | Kalamazoo, MI 49007-4711 |
Second Address | Kalamazoo, MI 49007-4711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |