Provider Demographics
NPI:1568814598
Name:KURTZ, AMY CATHERINE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:CATHERINE
Last Name:KURTZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CATHERINE
Other - Last Name:VANAUKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 DALE ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-4717
Mailing Address - Country:US
Mailing Address - Phone:937-631-1966
Mailing Address - Fax:
Practice Address - Street 1:864 CRAHEN AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-3477
Practice Address - Country:US
Practice Address - Phone:937-631-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIP676526235Z00000X
AZSLP14043235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist