Provider Demographics
NPI:1679678346
Name:KRAVETZ, JANINE (CAC-I)
Entity Type:Individual
Prefix:MS
First Name:JANINE
Middle Name:
Last Name:KRAVETZ
Suffix:
Gender:F
Credentials:CAC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 POLK ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-8247
Mailing Address - Country:US
Mailing Address - Phone:989-894-2991
Mailing Address - Fax:989-895-7669
Practice Address - Street 1:515 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5830
Practice Address - Country:US
Practice Address - Phone:989-894-2991
Practice Address - Fax:989-895-7669
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor