Provider Demographics
NPI:1437312535
Name:KRUCKENBERG, JENNIE LAUBER (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:LAUBER
Last Name:KRUCKENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4756 N DORMAN DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-9203
Mailing Address - Country:US
Mailing Address - Phone:785-633-8044
Mailing Address - Fax:
Practice Address - Street 1:4756 N DORMAN DR
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-9203
Practice Address - Country:US
Practice Address - Phone:785-633-8044
Practice Address - Fax:785-528-4144
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst