Individual
MS. KIMBERLY R DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5525 MARTIN ST, DETROIT, MI 48210-2329
(313) 457-6091
Mailing address
20074 RODEO CT, SOUTHFIELD, MI 48075-1283
(313) 506-6839
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401224625
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401006063
STATE LICENSE NUMBER
MI
Enumeration date
10/04/2006
Last updated
10/11/2024
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