Healthcare Provider Details

I. General information

NPI: 1053525055
Provider Name (Legal Business Name): JOSEPH PAUL KUCHENBUCH M.A., LLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 NORTH AVE
BATTLE CREEK MI
49017-3418
US

IV. Provider business mailing address

151 NORTH AVE
BATTLE CREEK MI
49017-3418
US

V. Phone/Fax

Practice location:
  • Phone: 269-968-2811
  • Fax: 269-968-2651
Mailing address:
  • Phone: 269-968-2811
  • Fax: 269-968-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301006838
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: