Healthcare Provider Details

I. General information

NPI: 1689113441
Provider Name (Legal Business Name): MRS. KIMBERLY JOY MEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 CENTURY LN STE 2
HOLLAND MI
49423-4318
US

IV. Provider business mailing address

4627 PINE DR
HOLLAND MI
49423-8922
US

V. Phone/Fax

Practice location:
  • Phone: 616-295-8284
  • Fax:
Mailing address:
  • Phone: 616-251-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: