Individual
DR. KRISTIN RAE GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1514 W MILHAM AVE, PORTAGE, MI 49024-1296
(269) 342-0606
Mailing address
1514 W MILHAM AVE, PORTAGE, MI 49024-1296
(269) 342-0606
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301014977
MI
Other
Enumeration date
10/05/2011
Last updated
01/03/2013
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