Doctor Name: | MRS. KRISTEN M KANSIEWICZ |
NPI Number: | 1053428722 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 113 Chestnut St Lynn, MA - 019022910 |
Business Phone Number: | 7813672383 |
Business Fax Number: | |
Mailing Address: | 126 Oxford St, Apt.205 LYNN |
State: | MA |
Postal Code: | 019011113 |
Phone Number: | 7813672383 |
Fax Number: | |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |