Provider Demographics
NPI:1093889354
Name:KREUTZER, DEE ANN ANN (MS LMHC ATR)
Entity Type:Individual
Prefix:MISS
First Name:DEE ANN
Middle Name:ANN
Last Name:KREUTZER
Suffix:
Gender:F
Credentials:MS LMHC ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W 21ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101
Mailing Address - Country:US
Mailing Address - Phone:505-769-2345
Mailing Address - Fax:505-769-8974
Practice Address - Street 1:1100 W 21ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:505-769-2345
Practice Address - Fax:505-769-8974
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health