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General NPI Number Information
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NPI Number | 1053455378
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Entity Type | Individual
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Provider Name | KASEY R MAGNUSON LLP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 325 84TH ST SW STE 103
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City | BYRON CENTER
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State | MI
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Zip | 49315-9350
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Country | US
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Telephone | 616-805-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 1466 CHASE LANE DR SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-9586
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Country | US
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Telephone | 616-443-7150
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Fax | 616-732-6392
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6361003491
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License Number State | MI
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