Individual
KIM KAROL JANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LLP
Contact information
Practice address
3230 BROADMOOR AVE SE STE D, KENTWOOD, MI 49512-8180
(616) 862-5603
Mailing address
3230 BROADMOOR AVE SE STE D, KENTWOOD, MI 49512-8180
(616) 862-5603
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361007869
MI
103T00000X
Psychologist
Primary
6362008901
MI
Other
Enumeration date
02/22/2017
Last updated
06/19/2026
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