Provider Demographics
NPI:1932444569
Name:LAURIE KRAUTH MA PLC
Entity type:Organization
Organization Name:LAURIE KRAUTH MA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MA LLP
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRAUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-973-3100
Mailing Address - Street 1:2002 HOGBACK RD STE 15
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9736
Mailing Address - Country:US
Mailing Address - Phone:734-973-3100
Mailing Address - Fax:
Practice Address - Street 1:2002 HOGBACK RD STE 15
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9736
Practice Address - Country:US
Practice Address - Phone:734-973-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-08
Last Update Date:2012-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009336103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty