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General NPI Number Information
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NPI Number | 1720446438
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Entity Type | Organization
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Legal Business Name | KATHERINE M. WALDEN, MD
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 2019 RAMBLING RD
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City | KALAMAZOO
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State | MI
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Zip | 49008-1630
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Country | US
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Telephone | 269-381-9511
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Fax | 269-381-9512
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Provider Business Mailing Address
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Address Line | 2019 RAMBLING RD
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City | KALAMAZOO
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State | MI
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Zip | 49008-1630
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Country | US
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Telephone | 269-381-9511
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Fax | 269-381-9512
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RENEE WEBB
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Credential |
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Telephone | 269-381-9511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 4301071370
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License Number State | MI
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