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General NPI Number Information
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NPI Number | 1598222952
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Entity Type | Organization
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Legal Business Name | KIMBERLEE K ERICKSON-WORPEL MA,LLP
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 3611 HENRY STREET
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City | NORTON SHORES
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State | MI
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Zip | 49441
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Country | US
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Telephone | 616-560-7264
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 HENRY STREET
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City | NORTON SHORES
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State | MI
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Zip | 49441
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Country | US
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Telephone | 616-560-7264
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Fax | 231-457-4068
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLEE K ERICKSON-WORPEL
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Credential | MA, LLP
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Telephone | 616-560-7264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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