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General NPI Number Information
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NPI Number | 1255093589
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Entity Type | Organization
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Legal Business Name | KIND WELLNESS GROUP LLC
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 110 E GRAND RIVER AVE
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City | HOWELL
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State | MI
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Zip | 48843-2252
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Country | US
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Telephone | 517-376-8730
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E GRAND RIVER AVE
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City | HOWELL
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State | MI
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Zip | 48843-2252
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Country | US
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Telephone | 517-295-3661
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | AMY NICHOLAS
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Credential | LMSW
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Telephone | 517-295-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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