Provider Demographics
NPI:1154640407
Name:CURTIS-NUTKINS, MICHELLE ZANG (LLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ZANG
Last Name:CURTIS-NUTKINS
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14126 COUNTY ROAD 428
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:MI
Mailing Address - Zip Code:49868-7762
Mailing Address - Country:US
Mailing Address - Phone:906-293-6117
Mailing Address - Fax:
Practice Address - Street 1:14126 COUNTY ROAD 428
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-7762
Practice Address - Country:US
Practice Address - Phone:906-293-6117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011972103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist