Healthcare Provider Details

I. General information

NPI: 1154626182
Provider Name (Legal Business Name): MARLENE G KUZEE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2011
Last Update Date: 01/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9445 GRANGE AVE NE
ROCKFORD MI
49341-9127
US

IV. Provider business mailing address

9445 GRANGE AVE NE
ROCKFORD MI
49341-9127
US

V. Phone/Fax

Practice location:
  • Phone: 616-450-7523
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801089712
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: