| Christine Dievendorf Weiss, Pllc | |
|
5400 Holiday Ter Ste 200a Kalamazoo MI 49009-2161 | |
| (269) 520-0050 | |
| (269) 520-0051 |
| Full Name | Christine Dievendorf Weiss, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5400 Holiday Ter Ste 200a, Kalamazoo, Michigan |
| Authorized Official Name and Position | Christine Dievendorf Weiss (OWNER) |
| Authorized Official Contact | 2695200050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine Dievendorf Weiss, Pllc 5400 Holiday Ter Ste 200a Kalamazoo MI 49009-2161 Ph: (269) 520-0050 | Christine Dievendorf Weiss, Pllc 5400 Holiday Ter Ste 200a Kalamazoo MI 49009-2161 Ph: (269) 520-0050 |
| NPI Number | 1821501933 |
|---|---|
| Provider Enumeration Date | 11/10/2017 |
| Last Update Date | 05/03/2020 |
| Certification Date | 05/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821501933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6401011020 (Michigan) | Primary |
| 103TC1900X | Psychologist - Counseling | 6301013930 (Michigan) | Secondary |
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