Individual
MISS KIMBERLY ANN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 833-2500
Mailing address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 833-2500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
MI
101YM0800X
Mental Health Counselor
Primary
—
MI
101YP1600X
Pastoral Counselor
—
MI
101YP2500X
Professional Counselor
—
MI
Other
Enumeration date
02/15/2011
Last updated
10/20/2021
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