Healthcare Provider Details

I. General information

NPI: 1720418817
Provider Name (Legal Business Name): KATHRYN THOMAS-PALMER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 07/15/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 LINWOOD AVE
ANN ARBOR MI
48103-6184
US

IV. Provider business mailing address

1902 LINWOOD AVE
ANN ARBOR MI
48103-3538
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-0209
  • Fax: 734-769-0224
Mailing address:
  • Phone: 734-288-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801087905
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: