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NPI Code Detail

MEDICARE: DR. TONICE KRUEGER LP

MEDICARE:  DR. TONICE  KRUEGER  LP
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 Counselor
2103TC0700XClinical Psychologist0810006082VA

General Provider Information

NPI Number : 1184949398
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TONICE KRUEGER LP
Provider Business Mailing Address
First Line : 4566 E HIGHWAY 20 STE 104
Second Line :
City : NICEVILLE
State : FL
Zip : 32578-8839
Country : US
Telephone Number : 850-842-2424
Fax Number : 850-897-0032
Provider Business Practice Location Address
First Line : 4566 E HIGHWAY 20 STE 104
Second Line :
City : NICEVILLE
State : FL
Zip : 32578-8839
Country : US
Telephone Number : 850-842-2424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2010
Last Update Date : 05/20/2020

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Directions to “ DR. TONICE KRUEGER LP” Practice Location

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