Individual
HERBERT CLINTON-COOPER KRUEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1613 M 139, BENTON HARBOR, MI 49022-5748
(269) 934-1694
Mailing address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 925-0585
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802089795
MI
Other
Enumeration date
01/10/2018
Last updated
12/22/2020
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