Healthcare Provider Details

I. General information

NPI: 1033495437
Provider Name (Legal Business Name): CYNTHIA MURRAY LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2011
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 JOHN ST
KALAMAZOO MI
49001-2854
US

IV. Provider business mailing address

601 JOHN ST BOX 42
KALAMAZOO MI
49007-5341
US

V. Phone/Fax

Practice location:
  • Phone: 269-286-7170
  • Fax: 269-286-7171
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number7201000253
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: