Provider Demographics
NPI:1417123340
Name:KURZ, ANN REGINA (MA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:REGINA
Last Name:KURZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:KURZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:16625 REDMOND WAY
Mailing Address - Street 2:SUITE M #114
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4444
Mailing Address - Country:US
Mailing Address - Phone:425-373-0808
Mailing Address - Fax:
Practice Address - Street 1:16307 NE 83RD ST
Practice Address - Street 2:SUITE 207
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-1501
Practice Address - Country:US
Practice Address - Phone:425-373-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601674303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health