Provider Demographics
NPI:1598818585
Name:CURTIN, THERESA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:J
Last Name:CURTIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 DUKE ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3224
Mailing Address - Country:US
Mailing Address - Phone:269-552-9299
Mailing Address - Fax:269-552-9298
Practice Address - Street 1:4415 DUKE ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3224
Practice Address - Country:US
Practice Address - Phone:269-552-9299
Practice Address - Fax:269-552-9298
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006728103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI68-0-C9-1166-0OtherBCBS OF MICHIGAN
MI68-0-C9-1166-0OtherBCBS OF MICHIGAN