| Doctor Name: | MRS. KRISTEN LYNNE MIKE |
| NPI Number: | 1548277304 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | |
| Business Practice Address: | 3013 S 101st Ln Tolleson, AZ - 853538338 |
| Business Phone Number: | 6232152627 |
| Business Fax Number: | |
| Mailing Address: | 3013 S 101st Ln, TOLLESON |
| State: | AZ |
| Postal Code: | 853538338 |
| Phone Number: | 6232152627 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 07/25/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |