Individual
KIMBERLY T DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22150 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
Mailing address
22150 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/26/2025
Last updated
06/18/2026
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