Provider Demographics
NPI:1225284482
Name:KRUG, ERIN CATHERINE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CATHERINE
Last Name:KRUG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:CATHERINE
Other - Last Name:SOKOLSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3523 CANTERBURY AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2856
Mailing Address - Country:US
Mailing Address - Phone:269-352-3187
Mailing Address - Fax:
Practice Address - Street 1:2615 HILL AN BROOK DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5620
Practice Address - Country:US
Practice Address - Phone:269-344-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007265225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist