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General NPI Number Information
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NPI Number | 1013723691
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Entity Type | Individual
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Provider Name | ANDREAS JENRICH LLC
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Gender | Male
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 471 W SOUTH ST STE 41B
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City | KALAMAZOO
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State | MI
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Zip | 49007-4673
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Country | US
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Telephone | 269-350-4143
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Fax |
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Provider Business Mailing Address
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Address Line | 6304 STURBRIDGE DR
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City | KALAMAZOO
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State | MI
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Zip | 49004-9652
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Country | US
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Telephone | 269-329-8948
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6451024055
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License Number State | MI
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