Provider Demographics
NPI:1235536780
Name:BELZER, JUDITH KRISTINA
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:KRISTINA
Last Name:BELZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3153 W HILL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3861
Mailing Address - Country:US
Mailing Address - Phone:248-885-0243
Mailing Address - Fax:
Practice Address - Street 1:3153 W HILL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3861
Practice Address - Country:US
Practice Address - Phone:248-885-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH6301016056103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis