Organization
THERAPY HUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE ALLEN KRUSE MA LMFT (OWNER/DIRECTOR)
(520) 678-1115
Entity
Organization
Contact information
Practice address
2876 SOLARRO DR, SIERRA VISTA, AZ 85635-6922
(520) 678-1115
Mailing address
2876 SOLARRO DR, SIERRA VISTA, AZ 85635-6922
(520) 678-1115
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
454007
AZ
106H00000X
Marriage & Family Therapist
Primary
LMFT 10273
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43535
CALIFORNIA MARRIAGE AND FAMIYL THERAPIST
CA
01
—
LMFT10273
ARIZONA MARRIAGE AND FAMILY THERAPIST
AZ
Enumeration date
07/31/2010
Last updated
07/31/2010
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