Individual
KIM KAROL JANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., TLLP
Contact information
Practice address
1550 E BELTLINE AVE SE STE 250, GRAND RAPIDS, MI 49506-4364
(616) 558-5915
Mailing address
1550 E BELTLINE AVE SE STE 250, GRAND RAPIDS, MI 49506-4364
(616) 558-5915
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362008901
MI
Other
Enumeration date
02/22/2017
Last updated
08/24/2020
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