Healthcare Provider Details

I. General information

NPI: 1750977971
Provider Name (Legal Business Name): JAMEE PATRICIA KRAAI LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2020
Last Update Date: 12/13/2020
Certification Date: 12/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MONROE AVE NW STE 319
GRAND RAPIDS MI
49503-1451
US

IV. Provider business mailing address

6934 ADARIDGE DR SE
ADA MI
49301-9028
US

V. Phone/Fax

Practice location:
  • Phone: 616-275-4646
  • Fax:
Mailing address:
  • Phone: 765-618-2576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401014673
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: