Individual
KATHERINE LISA ROSENBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4250 PLYMOUTH RD, ANN ARBOR, MI 48109-2700
(734) 764-6443
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301009810
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68-0-H1-1303-0
BCBS MICHIGAN PIN
MI
Enumeration date
02/05/2008
Last updated
03/19/2009
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