Kaitlyn Sue Wixson
Counselor, Professional in Jackson, MI. Individual provider (NPI-1).
NPI number1629621925
StatusActive
Last updated in NPPESJul 17, 2019
Details
- NPI
- 1629621925
- Entity type
- Individual (NPI-1)
- Name
- Kaitlyn Sue Wixson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 17, 2019
- Last updated
- Jul 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
330 W Michigan AveJackson, MI 49201-2121
Phone 517-787-7920
Mailing address
4914 Churchill RdLeslie, MI 49251-9794
Phone 517-392-8110
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