Provider Demographics
NPI:1336583384
Name:KURTZ, ANGELA M (LLPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:KURTZ
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 4TH ST
Mailing Address - Street 2:P.O. BOX 217
Mailing Address - City:ALPHA
Mailing Address - State:MI
Mailing Address - Zip Code:49902
Mailing Address - Country:US
Mailing Address - Phone:906-284-3420
Mailing Address - Fax:906-265-2004
Practice Address - Street 1:117 W GENESEE ST STE 9
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:MI
Practice Address - Zip Code:49935-1497
Practice Address - Country:US
Practice Address - Phone:906-265-2000
Practice Address - Fax:906-265-2004
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health