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NPI Code Detail

MEDICARE: REBECCA KALKMAN MA, LLP

MEDICARE: REBECCA KALKMAN MA, LLP
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
1103T00000XPsychologist6361008095MI

General Provider Information

NPI Number : 1902553134
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA KALKMAN MA, LLP
Provider Business Mailing Address
First Line : 890 WASHINGTON AVE STE 150
Second Line :
City : HOLLAND
State : MI
Zip : 49423-7702
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 136TH AVE STE 416
Second Line :
City : HOLLAND
State : MI
Zip : 49424-2905
Country : US
Telephone Number : 616-952-9957
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2022
Last Update Date : 10/08/2024

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Directions to “ REBECCA KALKMAN MA, LLP” Practice Location

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