Individual
KARLA MARIE AVERILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LLP
Contact information
Practice address
890 N 10TH ST, KALAMAZOO, MI 49009-6192
(269) 427-8400
Mailing address
6700 BRUTUS RD, BRUTUS, MI 49716-9710
(623) 337-2747
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361003377
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12345
—
MI
Enumeration date
06/19/2020
Last updated
06/19/2020
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