Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 6401006621 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301010885 | MI |
NPI | 1245451285 |
---|---|
Provider Name | Ms. Kathleen T, Winters |
First Address | Kalamazoo, MI 49006-1925 |
Second Address | Kalamazoo, MI 49007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |