Individual
TAMARA KREIFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
521 E ELLEN ST, FENTON, MI 48430-2122
(810) 931-9092
Mailing address
521 E ELLEN ST, FENTON, MI 48430-2122
(810) 931-9092
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
247200000X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247200000X
TECHNICIAN
MI
Enumeration date
09/15/2016
Last updated
09/15/2016
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