Healthcare Provider Details

I. General information

NPI: 1285234062
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL KEMP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 CARPENTER RD
ANN ARBOR MI
48108-1108
US

IV. Provider business mailing address

1710 HERMITAGE RD
ANN ARBOR MI
48104-4503
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-1073
  • Fax:
Mailing address:
  • Phone: 206-353-7237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: