Individual
KATHRYN L WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
1050 SILVER DR, TRAVERSE CITY, MI 49684-5749
(231) 947-2255
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301014728
MI
Other
Enumeration date
02/24/2011
Last updated
01/30/2012
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