Provider Demographics
NPI:1861942963
Name:KREUTZER, MICHELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KREUTZER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 N SAUNDERS AVE
Mailing Address - Street 2:PO BOX 590
Mailing Address - City:SUTTON
Mailing Address - State:NE
Mailing Address - Zip Code:68979-2406
Mailing Address - Country:US
Mailing Address - Phone:402-773-5569
Mailing Address - Fax:402-773-5578
Practice Address - Street 1:1107 N SAUNDERS AVE
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:NE
Practice Address - Zip Code:68979-2406
Practice Address - Country:US
Practice Address - Phone:402-773-5569
Practice Address - Fax:402-773-5578
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist