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NPI Code Detail

MEDICARE: KYRRA A SPRINGER

MEDICARE: KYRRA A SPRINGER
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
1101YM0800XMental Health Counselor6802085842MI

General Provider Information

NPI Number : 1063538049
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYRRA A SPRINGER
Provider Business Mailing Address
First Line : 3046 SIGNATURE BLVD
Second Line : APT A
City : ANN ARBOR
State : MI
Zip : 48103-6916
Country : US
Telephone Number : 248-668-0922
Fax Number : 248-668-0924
Provider Business Practice Location Address
First Line : 2045 E WEST MAPLE RD
Second Line : D405
City : COMMERCE TOWNSHIP
State : MI
Zip : 48390-3801
Country : US
Telephone Number : 248-668-0922
Fax Number : 248-668-0924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 07/08/2007

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Directions to “ KYRRA A SPRINGER ” Practice Location

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