Individual
KAILEY MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14126 BAINBRIDGE ST, LIVONIA, MI 48154-4302
(734) 307-8532
Mailing address
14126 BAINBRIDGE ST, LIVONIA, MI 48154-4302
(734) 307-8532
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009530
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/17/2021
Last updated
09/15/2022
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