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Individual

KIMBERLY RUTH TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4880 LAWNDALE ST, DETROIT, MI 48210-2010
(313) 846-6030
(313) 846-7718
Mailing address
20066 MIDWAY AVE, SOUTHFIELD, MI 48075-3813
(248) 943-5196

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401011150
MI
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
6401011150
MI
101YS0200X
School Counselor
IF0000000185872
MI

Other

Enumeration date
07/22/2011
Last updated
02/28/2024
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