Provider Demographics
NPI:1952830440
Name:KAUFMAN, BREE KATELYNN (MA, TLLP)
Entity Type:Individual
Prefix:
First Name:BREE
Middle Name:KATELYNN
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MA, TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 HEMMETER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3944
Mailing Address - Country:US
Mailing Address - Phone:989-799-2100
Mailing Address - Fax:989-799-2637
Practice Address - Street 1:2100 HEMMETER RD.
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603
Practice Address - Country:US
Practice Address - Phone:989-799-2100
Practice Address - Fax:989-799-2637
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301017042103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical