Healthcare Provider Details

I. General information

NPI: 1215831078
Provider Name (Legal Business Name): KATHLEEN ANN KENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 W DRAHNER RD
OXFORD MI
48371-4866
US

IV. Provider business mailing address

8236 BROOKSTONE LN
CLARKSTON MI
48348-4474
US

V. Phone/Fax

Practice location:
  • Phone: 248-969-5000
  • Fax:
Mailing address:
  • Phone: 248-860-0910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851122582
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: