Individual
DR. CHARLES RICHARD SPATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1000 OAKLAND DR, PSYCHOLOGY CLINIC, KALAMAZOO, MI 49008-1282
(269) 387-8302
(269) 387-4550
Mailing address
4715 CARVER DR, KALAMAZOO, MI 49009-9504
(269) 599-6869
(269) 387-4550
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301002505
MI
103TC0700X
Clinical Psychologist
Primary
6301002505
MI
103TH0100X
Health Service Psychologist
6301002505
MI
Other
Enumeration date
04/25/2015
Last updated
04/25/2015
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