| Tamra M Krutz Ma Lpc Pa | |
|
708 W Superior St Ste B Sandpoint ID 83864-1633 | |
| (208) 265-3579 | |
| (208) 204-0182 |
| Full Name | Tamra M Krutz Ma Lpc Pa |
|---|---|
| Speciality | Counselor |
| Location | 708 W Superior St Ste B, Sandpoint, Idaho |
| Authorized Official Name and Position | Tamra M Krutz (PRESIDENT) |
| Authorized Official Contact | 2082653579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamra M Krutz Ma Lpc Pa 708 W Superior St Ste B Sandpoint ID 83864-1633 Ph: (208) 265-3579 | Tamra M Krutz Ma Lpc Pa 708 W Superior St Ste B Sandpoint ID 83864-1633 Ph: (208) 265-3579 |
| NPI Number | 1760243851 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Medicare PECOS PAC ID | 4789020124 |
|---|---|
| Medicare Enrollment ID | O20240307004097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760243851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tamra Mae Krutz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093904112 PECOS PAC ID: 8224474663 Enrollment ID: I20240307004117 |
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