Provider Demographics
NPI:1790008167
Name:ROW, KATHRYN LEE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LEE
Last Name:ROW
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50480 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-6667
Mailing Address - Country:US
Mailing Address - Phone:734-552-1996
Mailing Address - Fax:
Practice Address - Street 1:50480 MONROE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-6667
Practice Address - Country:US
Practice Address - Phone:734-552-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional