Healthcare Provider Details

I. General information

NPI: 1457462152
Provider Name (Legal Business Name): AMY KURTTI L.B.S.W., M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 E NEWELL ST BOX 867
WHITE CLOUD MI
49349-8795
US

IV. Provider business mailing address

22901 DEWEY RD
HOWARD CITY MI
49329-9472
US

V. Phone/Fax

Practice location:
  • Phone: 231-689-7330
  • Fax: 231-689-7345
Mailing address:
  • Phone: 231-689-7330
  • Fax: 231-689-7345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6802077668
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: