Organization Name: | MADE FOR KIDS, INC. |
NPI Number: | 1205078532 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTEN MICHENER (CLINICAL PSYCHOLOGIST/CO-OWNER) |
Mailing Address: | 182 Ben Burton Cir Suite 100 Bogart |
State: | GA US |
Postal Code: | 306226847 |
Phone Number: | 7069953160 |
Fax Number: | 7062434611 |
NPI Enumeration Date: | 04/01/2009 |
NPI Last Update Date: | 04/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY003136 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |