Individual
KATHLEEN MARGARET HAGELTHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1 FORD PL STE 2E, DETROIT, MI 48202-3450
(313) 874-4689
Mailing address
ONE FORD PLACE, STE 2E, HENRY FORD HEALTH SYSTEM, DETROIT, MI 48202
(313) 874-4689
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301014115
MI
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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