Healthcare Provider Details

I. General information

NPI: 1477460467
Provider Name (Legal Business Name): MICHAELA RENE KRUGAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 NEWTOWN YARDLEY RD STE 203
NEWTOWN PA
18940-4011
US

IV. Provider business mailing address

35 ICE POND RD
LEVITTOWN PA
19057-2705
US

V. Phone/Fax

Practice location:
  • Phone: 215-344-7342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC017460
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: