Provider Demographics
NPI:1922213370
Name:HUSTON KAMERMAN, PATRICIA (MA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HUSTON KAMERMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E. WESTWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-4341
Mailing Address - Country:US
Mailing Address - Phone:269-492-6471
Mailing Address - Fax:269-492-6473
Practice Address - Street 1:900 PEELER STREET
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008
Practice Address - Country:US
Practice Address - Phone:269-492-6471
Practice Address - Fax:269-492-6473
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007079103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling