Individual
DR. KRISTINE ELLEN FREEARK-ZUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
916 FULLER ST, ANN ARBOR, MI 48104-1215
(734) 668-0140
(734) 995-1172
Mailing address
3525 DALEVIEW DR, ANN ARBOR, MI 48105-9686
(734) 668-0140
(734) 995-1172
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301002719
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11276437
CAQH PROVIDER ID
MI
01
—
61-20013
PHPSM,UNITED HEALTHCARE
MI
01
—
68-0-H1-4729-0
BCBS PROVIDER ID
MI
Enumeration date
03/02/2007
Last updated
08/05/2009
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