Doctor Name: | MS. KATHRYN BOEGEL TIEFENTHAL |
NPI Number: | 1306032677 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.W. |
License Number: | 6802066029 |
Business Practice Address: | 103 S 4th St Sturgis, MI - 490911819 |
Business Phone Number: | 2696513902 |
Business Fax Number: | 2696594874 |
Mailing Address: | 3151 W B Ave, PLAINWELL |
State: | MI |
Postal Code: | 490808602 |
Phone Number: | 2693438843 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2007 |
NPI Last Update Date: | 09/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6802066029 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |