Organization
KLOTT PSYCHOLOGICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA ANN KLOTT PH.D. (OWNER)
(616) 204-5828
Entity
Organization
Contact information
Practice address
233 FULTON ST E, SUITE 24, GRAND RAPIDS, MI 49503-3200
(616) 204-5828
Mailing address
P. O. BOX 1767, GRAND RAPIDS, MI 49501
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301015303
MI
103TC0700X
Clinical Psychologist
Primary
6301015303
MI
103TC1900X
Counseling Psychologist
6301015303
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301015303
MI
103TF0000X
Family Psychologist
6301015303
MI
103TH0100X
Health Service Psychologist
6301015303
MI
103TP2701X
Group Psychotherapy Psychologist
6301015303
MI
Other
Enumeration date
03/01/2013
Last updated
03/18/2014
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