Provider Demographics
NPI:1114790946
Name:KRUGER, CATHRYN ANN (APCC)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:ANN
Last Name:KRUGER
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33812 MALAGA DR APT B
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-6450
Mailing Address - Country:US
Mailing Address - Phone:847-337-2700
Mailing Address - Fax:
Practice Address - Street 1:33812 MALAGA DR APT B
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-6450
Practice Address - Country:US
Practice Address - Phone:847-337-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
APCC10123101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor