Doctor Name: | MS. BEVERLY S. KLUZAK |
NPI Number: | 1356380299 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801062459 |
Business Practice Address: | 3285 122nd Ave Po Drawer 130 Allegan, MI - 490109511 |
Business Phone Number: | 2696736617 |
Business Fax Number: | 2696732738 |
Mailing Address: | 3285 122nd Ave, Po Drawer 130 ALLEGAN |
State: | MI |
Postal Code: | 490109511 |
Phone Number: | 2696736617 |
Fax Number: | 2696732738 |
NPI Enumeration Date: | 06/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6801062459 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |