Healthcare Provider Details

I. General information

NPI: 1548045479
Provider Name (Legal Business Name): KAITLIN M TUINSTRA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAITLIN HAMACHER

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 68TH ST SE
GRAND RAPIDS MI
49548-6927
US

IV. Provider business mailing address

300 68TH ST SE
GRAND RAPIDS MI
49548-6927
US

V. Phone/Fax

Practice location:
  • Phone: 616-455-5000
  • Fax:
Mailing address:
  • Phone: 616-455-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6352000637
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019573
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: