Provider Demographics
NPI:1437762937
Name:KITTINGER, DAUN SEPTEMBRA - MICHELLE (MSW)
Entity Type:Individual
Prefix:
First Name:DAUN
Middle Name:SEPTEMBRA - MICHELLE
Last Name:KITTINGER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7540 ECKERT RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MI
Mailing Address - Zip Code:49237-9543
Mailing Address - Country:US
Mailing Address - Phone:269-967-2768
Mailing Address - Fax:
Practice Address - Street 1:7540 ECKERT RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MI
Practice Address - Zip Code:49237-9543
Practice Address - Country:US
Practice Address - Phone:269-967-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802088787104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker