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NPI Code Detail

MEDICARE: KIRSTEN HERMANN L.M.F.T.

MEDICARE: KIRSTEN HERMANN L.M.F.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0069212NM

General Provider Information

NPI Number : 1679592935
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTEN HERMANN L.M.F.T.
Provider Business Mailing Address
First Line : PO BOX 2952
Second Line :
City : CORRALES
State : NM
Zip : 87048-2952
Country : US
Telephone Number : 505-899-3544
Fax Number : 815-346-2321
Provider Business Practice Location Address
First Line : 4686 CORRALES RD
Second Line :
City : CORRALES
State : NM
Zip : 87048-8610
Country : US
Telephone Number : 505-899-3544
Fax Number : 815-346-2321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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