Individual
KATEN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2314 MONROE ST, DEARBORN, MI 48124-3045
(313) 565-5937
Mailing address
2314 MONROE ST, DEARBORN, MI 48124-3045
(313) 565-5937
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6774766
MI
Other
Enumeration date
01/28/2007
Last updated
07/08/2007
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