Individual
DR. LINDA KUKUK HAUBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1139 E FRONT ST, TRAVERSE CITY, MI 49686
(231) 947-7082
(231) 947-1911
Mailing address
3045 OJIBWA TRAIL, TRAVERSE CITY, MI 49686
(231) 947-7082
(231) 947-1911
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301008535
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680B83299
BLUE CROSS BS
MI
Enumeration date
03/13/2007
Last updated
07/08/2007
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