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General NPI Number Information
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NPI Number | 1417167065
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Entity Type | Individual
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Provider Name | KATHLEEN BURNS JAGER PH.D., LMFT, LLP
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 02/18/2013
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Provider Practice Location Address
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Address Line | 908 E MOUNT HOPE AVE PERSPECTIVES THERAPY SERVICES
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City | LANSING
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State | MI
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Zip | 48910-3262
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Country | US
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Telephone | 517-719-8715
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Fax |
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Provider Business Mailing Address
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Address Line | 482 ANHINGA DR
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City | EAST LANSING
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State | MI
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Zip | 48823-8662
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Country | US
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Telephone | 517-719-8715
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Fax |
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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 | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 6301010528
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006266
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License Number State | MI
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