Organization
KRUEGER INTEGRATIVE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONICE KRUEGER LCP (LICENCED PSYCHOLOGIST, DIRECTOR)
(619) 865-9399
Entity
Organization
Contact information
Practice address
4893 PRINCE WILLIAM PKWY, WOODBRIDGE, VA 22192-5403
(850) 565-9710
Mailing address
4467 NEW MARKET RD, NICEVILLE, FL 32578-4915
(619) 865-9399
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184949398
NPI 1
—
Enumeration date
05/28/2019
Last updated
05/28/2019
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