Healthcare Provider Details

I. General information

NPI: 1265367890
Provider Name (Legal Business Name): JOSEANNA MARIA HATCHETT-KIMBALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S 1ST ST
ANN ARBOR MI
48104-1306
US

IV. Provider business mailing address

200 S 1ST ST
ANN ARBOR MI
48104-1306
US

V. Phone/Fax

Practice location:
  • Phone: 248-312-9188
  • Fax:
Mailing address:
  • Phone: 248-312-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451009055
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: