| Doctor Name: | KIM MARIE TOCCO |
| NPI Number: | 1225058498 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 4704177587 |
| Business Practice Address: | 131 Kercheval Ave Suite 390 Grosse Pointe Farms, MI - 482363629 |
| Business Phone Number: | 3138856400 |
| Business Fax Number: | 3138856807 |
| Mailing Address: | 131 Kercheval Ave, Suite 390 GROSSE POINTE FARMS |
| State: | MI |
| Postal Code: | 482363629 |
| Phone Number: | 3138856400 |
| Fax Number: | 3138856807 |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 4704177587 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |