Provider Demographics
NPI:1396563813
Name:LOVE, KATHY GALE
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:GALE
Last Name:LOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31550 CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1738
Mailing Address - Country:US
Mailing Address - Phone:734-278-9494
Mailing Address - Fax:
Practice Address - Street 1:31550 CHESTER ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1738
Practice Address - Country:US
Practice Address - Phone:734-278-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor