Provider Demographics
NPI:1316606783
Name:HARTUNG-MANUEL, DENISE A
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:HARTUNG-MANUEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:HARTUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:519 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5117
Mailing Address - Country:US
Mailing Address - Phone:269-903-0535
Mailing Address - Fax:269-383-2204
Practice Address - Street 1:519 S PARK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5117
Practice Address - Country:US
Practice Address - Phone:269-903-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker