Individual
MARY D KRUITHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10039 10 MILE RD, EVART, MI 49631-7313
(231) 629-6393
Mailing address
PO BOX 84, EVART, MI 49631-0084
(231) 629-6393
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401011846
MI
101YP2500X
Professional Counselor
Primary
6401017199
MI
103TC1900X
Counseling Psychologist
6301014054
MI
Other
Enumeration date
10/08/2010
Last updated
08/19/2022
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