Provider Demographics
NPI:1497807952
Name:SCHUMACHER, KIMBERLY ANN (LLP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:SCHUMACHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLP
Mailing Address - Street 1:1655 ODETTE ST
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-3446
Mailing Address - Country:US
Mailing Address - Phone:734-502-9022
Mailing Address - Fax:
Practice Address - Street 1:17940 FARMINGTON RD
Practice Address - Street 2:SUITE 280
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-4444
Practice Address - Country:US
Practice Address - Phone:800-693-1916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI915044103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical