Individual
KIM THERESE PAUWELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LLP
Contact information
Practice address
8245 HOLLY RD STE 200, GRAND BLANC, MI 48439-2483
(800) 693-1916
Mailing address
1108 KURTZ RD, HOLLY, MI 48442-8314
(248) 790-7688
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361002044
MI
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
6301013202
MI
Other
Enumeration date
11/09/2009
Last updated
08/10/2022
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