Provider Demographics
NPI:1992401160
Name:KUNTZ, MICHELLE MARIE (MSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 MARLBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2029
Mailing Address - Country:US
Mailing Address - Phone:631-893-0002
Mailing Address - Fax:
Practice Address - Street 1:93 MARLBOROUGH RD
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2029
Practice Address - Country:US
Practice Address - Phone:631-893-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker