Doctor Name: | DARCY KRAUSE |
NPI Number: | 1003273830 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6301007838 |
Business Practice Address: | 6556 Bella Vista Dr Ne 26 N Main St Rockford, MI - 493417861 |
Business Phone Number: | 6169512369 |
Business Fax Number: | |
Mailing Address: | 6556 Bella Vista Dr Ne, ROCKFORD |
State: | MI |
Postal Code: | 493417861 |
Phone Number: | 6169512369 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2016 |
NPI Last Update Date: | 01/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6301007838 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |