Individual
KIMBERLY ANN FERNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC, DP-C
Contact information
Practice address
1255 N OAKLAND BLVD, WATERFORD, MI 48327-1545
(248) 599-8999
Mailing address
21225 DANBURY ST, WOODHAVEN, MI 48183-1607
(734) 778-2121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6451022000
MI
101YM0800X
Mental Health Counselor
6451022000
MI
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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