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General NPI Number Information
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NPI Number | 1073183315
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Entity Type | Organization
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Legal Business Name | DEBORAH KRIEGEL LLC
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 2410 GRAPE RD STE 1
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City | MISHAWAKA
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State | IN
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Zip | 46545-3015
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Country | US
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Telephone | 574-243-9370
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Fax | 574-243-9375
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Provider Business Mailing Address
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Address Line | 2410 GRAPE RD STE 1
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City | MISHAWAKA
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State | IN
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Zip | 46545-3015
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Country | US
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Telephone | 574-243-9370
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Fax | 574-243-9375
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Authorized Official
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Title or Position | CEO
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Name | DEBORAH KRIEGEL
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Credential | LMHC
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Telephone | 574-514-9646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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