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NPI Code Detail

MEDICARE: MAJESTY KATHREN RICHARDSON

MEDICARE: MAJESTY KATHREN RICHARDSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianR263577149169MI

General Provider Information

NPI Number : 1265247944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAJESTY KATHREN RICHARDSON
Provider Business Mailing Address
First Line : 2400 NILES AVE
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-1922
Country : US
Telephone Number : 262-337-2292
Fax Number :
Provider Business Practice Location Address
First Line : 2400 NILES AVE
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-1922
Country : US
Telephone Number : 262-337-2292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2025
Last Update Date : 02/10/2025

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Directions to “ MAJESTY KATHREN RICHARDSON ” Practice Location

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