Individual
MS. CHRISTINE DIEVENDORF WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
5400 HOLIDAY TER STE 200A, KALAMAZOO, MI 49009-2161
(269) 520-0050
(269) 520-0051
Mailing address
5400 HOLIDAY TER STE 200A, KALAMAZOO, MI 49009-2161
(269) 520-0050
(269) 520-0051
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401011020
MI
101YP2500X
Professional Counselor
L1556549
MI
103TC1900X
Counseling Psychologist
Primary
L1393931
MI
Other
Enumeration date
06/25/2009
Last updated
09/29/2023
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