| Kim D. Kemske, Psy.d., L.p., P.c. | |
|
24505 Meadowbrook Rd Novi MI 48375-2845 | |
| (248) 615-1263 | |
| Not Available |
| Full Name | Kim D. Kemske, Psy.d., L.p., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 24505 Meadowbrook Rd, Novi, Michigan |
| Authorized Official Name and Position | Kim D. Kemske (PRESIDENT) |
| Authorized Official Contact | 2486151263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim D. Kemske, Psy.d., L.p., P.c. 24505 Meadowbrook Rd Novi MI 48375-2845 Ph: () - | Kim D. Kemske, Psy.d., L.p., P.c. 24505 Meadowbrook Rd Novi MI 48375-2845 Ph: (248) 615-1263 |
| NPI Number | 1669790341 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 05/05/2010 |
| Medicare PECOS PAC ID | 4880877562 |
|---|---|
| Medicare Enrollment ID | O20110318000293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669790341 | NPI | - | NPPES |
| MI1405 | Other | MI | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301013347 (Michigan) | Primary |
| Provider Name | Kim D Kemske |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083606446 PECOS PAC ID: 3577625797 Enrollment ID: I20081223000297 |
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