Healthcare Provider Details

I. General information

NPI: 1104617034
Provider Name (Legal Business Name): KRISTEN M BEHAR ALLEN LICENCED MASSAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 W 1ST ST
DERIDDER LA
70634-3863
US

IV. Provider business mailing address

PO BOX 275
ROSEPINE LA
70659-0275
US

V. Phone/Fax

Practice location:
  • Phone: 940-218-3134
  • Fax:
Mailing address:
  • Phone: 940-218-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA10088
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: