Provider Demographics
NPI:1548045479
Name:TUINSTRA, KAITLIN M (PSYD)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:M
Last Name:TUINSTRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:HAMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6500 BYRON CENTER AVE SW STE 300
Mailing Address - Street 2:
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-9083
Mailing Address - Country:US
Mailing Address - Phone:616-295-7010
Mailing Address - Fax:
Practice Address - Street 1:6500 BYRON CENTER AVE SW
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-9080
Practice Address - Country:US
Practice Address - Phone:616-281-6311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6352000637103G00000X, 103TC0700X
MI6351004673103T00000X
MI6301019573103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist