| Doctor Name: | GARRICK T KREITZER |
| NPI Number: | 1447552906 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NCC, CADC, LPCA |
| License Number: | 1020 |
| Business Practice Address: | 467 Erlanger Rd #2 Erlanger, KY - 410181496 |
| Business Phone Number: | 8595128627 |
| Business Fax Number: | 8599180740 |
| Mailing Address: | 467 Erlanger Rd, #2 ERLANGER |
| State: | KY |
| Postal Code: | 410181496 |
| Phone Number: | 8595128627 |
| Fax Number: | 8599180740 |
| NPI Enumeration Date: | 12/03/2010 |
| NPI Last Update Date: | 12/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1020 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |