Individual
DR. THERESA ANNE KRUCZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
100 N TILLOTSON AVE, MUNCIE, IN 47304-3987
(765) 729-0152
Mailing address
4105 W JACKSON ST, MUNCIE, IN 47304-3612
(765) 729-0152
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041547A
IN
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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