Individual
KIM NWAGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IMH-E
Contact information
Practice address
46931 ELMSMERE DR, NORTHVILLE, MI 48167-3302
(248) 212-7216
(248) 233-6373
Mailing address
46931 ELMSMERE DR, NORTHVILLE, MI 48167-3302
(248) 212-7216
(248) 233-6373
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
372500000X
Chore Provider
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376963538
—
MI
Enumeration date
05/08/2019
Last updated
05/08/2019
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