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NPI Code Detail

MEDICARE: MRS. KERSTYN GUTENSCHWAGER LLMSW

MEDICARE:  MRS. KERSTYN  GUTENSCHWAGER  LLMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6851119295MI

General Provider Information

NPI Number : 1043020704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KERSTYN GUTENSCHWAGER LLMSW
Provider Business Mailing Address
First Line : 7730 SMALE ST
Second Line :
City : WASHINGTON TWP
State : MI
Zip : 48094-3501
Country : US
Telephone Number : 248-285-1085
Fax Number :
Provider Business Practice Location Address
First Line : 7730 SMALE ST
Second Line :
City : WASHINGTON TWP
State : MI
Zip : 48094-3501
Country : US
Telephone Number : 248-285-1085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2025
Last Update Date : 01/13/2025

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Directions to “ MRS. KERSTYN GUTENSCHWAGER LLMSW” Practice Location

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