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General NPI Number Information
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NPI Number | 1821808908
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Entity Type | Individual
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Provider Name | KATHLEEN RENEE MUNOZ LLMFT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 100 MAPLE ST STE 215
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City | WYANDOTTE
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State | MI
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Zip | 48192-5966
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Country | US
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Telephone | 734-361-1416
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Fax |
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Provider Business Mailing Address
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Address Line | 2361 GORNO ST
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City | TRENTON
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State | MI
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Zip | 48183-2546
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Country | US
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Telephone | 912-332-3584
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4151001117
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License Number State | MI
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