Provider Demographics
NPI:1861637282
Name:ZELL, KATHERINE A (LLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:ZELL
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22190 W. 9 MILE RD.
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-357-8187
Mailing Address - Fax:248-350-3159
Practice Address - Street 1:22190 W. 9 MILE RD.
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-357-8187
Practice Address - Fax:248-350-3159
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILLP103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical