Healthcare Provider Details

I. General information

NPI: 1487032330
Provider Name (Legal Business Name): KRISTIN SJOBERG MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 YATES ST
DENVER CO
80219-1034
US

IV. Provider business mailing address

163 YATES ST
DENVER CO
80219-1034
US

V. Phone/Fax

Practice location:
  • Phone: 507-951-6967
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: