NPI Profile for KIMBERLY A DOUGLAS in DETROIT, MI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Counselor |
101Y00000X | |||
Pastoral |
101YP1600X | |||
Professional |
101YP2500X |
| NPI Number | 1932406659 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 02/15/2011 | |
| Last updated | 10/20/2021 - About 5 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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KIMBERLY A DOUGLAS
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