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Individual

MR. KEVIN CHRISTOPHER KROUSE I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CADC-II, DOT/SAP

Contact information

Practice address
11000 W MCNICHOLS RD, SUITE B3, DETROIT, MI 48221-2357
(313) 863-5554
(313) 863-4711
Mailing address
1126 CORONEL STREET, SAN FERNANDO, CA 91340-2357
(323) 743-9389

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
821045
MI
172V00000X
Community Health Worker
Primary
A044070417
CA

Other

Enumeration date
02/05/2009
Last updated
03/03/2025
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