Provider Demographics
NPI:1942354733
Name:KUZEE, MARIELLE RUTH (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARIELLE
Middle Name:RUTH
Last Name:KUZEE
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 1:3924 BASSWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2006
Mailing Address - Country:US
Mailing Address - Phone:616-538-9072
Mailing Address - Fax:
Practice Address - Street 1:3924 BASSWOOD DR SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2006
Practice Address - Country:US
Practice Address - Phone:616-538-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801067421101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health