Individual
KIMBERLEE JEAN PROSE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
933 3 MILE RD NW, GRAND RAPIDS, MI 49544-1673
(616) 222-3720
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010702
MI
Other
Enumeration date
06/25/2006
Last updated
07/09/2007
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