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General NPI Number Information
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NPI Number | 1265983472
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Entity Type | Organization
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Legal Business Name | KATHY CHEN PSYD PLLC
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Dates
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Enumeration Date | 10/23/2016
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Last Update Date | 10/23/2016
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Provider Practice Location Address
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Address Line | 17376 W 12 MILE RD SUITE 102
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2118
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Country | US
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Telephone | 312-479-8193
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Fax |
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Provider Business Mailing Address
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Address Line | 1558 DONNA AVE
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-2051
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Country | US
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Telephone | 312-479-8193
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KATHY CHEN
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Credential | PSYD
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Telephone | 312-479-8193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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