Provider Information for 1528346707
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KIMBERLY RUTH TAYLOR LPC
Sex: Female
NPI: 1528346707
Last Updated: 2024-02-28
Certification Date: 2024-02-28
Certification Date: 2024-02-28
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1528346707 | ||||||||||||||||||||
| Enumeration Date | 2011-07-22 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 20066 MIDWAY AVE SOUTHFIELD, MI 48075-3813 United States Phone: 248-943-5196 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 4880 LAWNDALE ST DETROIT, MI 48210-2010 United States Phone: 313-846-6030 | Fax:313-846-7718 | ||||||||||||||||||||
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