Individual
KATHARINE C DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
107 E STATE ST, TRAVERSE CITY, MI 49684-2512
(231) 946-4419
Mailing address
529 6TH ST, TRAVERSE CITY, MI 49684-2417
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301005697
MI
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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