Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 6351004125 | MI |
Y | 103T00000X | Psychologist | 6351004125 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6351004125 | MI |
N | 103G00000X | Clinical Psychologist | 6351004125 | MI |
N | 103TC0700X | Clinical Psychologist | 6351004125 | MI |
NPI | 1144820598 |
---|---|
Provider Name | Alexander William Krieg |
First Address | Franklin, MI 48025-1367 |
Second Address | Franklin, MI 48025-1367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2020 |
Last Update Date | 13/05/2021 |