Healthcare Provider Details

I. General information

NPI: 1598164857
Provider Name (Legal Business Name): DESIREA KRING LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 PATIENT CARE DR STE 101
LANSING MI
48911-4276
US

IV. Provider business mailing address

2460 WALENJUS CT
HOLT MI
48842-9703
US

V. Phone/Fax

Practice location:
  • Phone: 517-882-3732
  • Fax:
Mailing address:
  • Phone: 517-974-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801096281
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: