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General NPI Number Information
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NPI Number | 1023653060
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Entity Type | Individual
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Provider Name | KRISTINA DINGUS KEUHLEN PHD
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Gender | Female
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 04/09/2023
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Provider Practice Location Address
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Address Line | 5512 W PLANO PKWY STE 300
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City | PLANO
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State | TX
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Zip | 75093-4840
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Country | US
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Telephone | 972-841-9171
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Fax |
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Provider Business Mailing Address
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Address Line | 5512 W PLANO PKWY STE 300
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City | PLANO
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State | TX
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Zip | 75093-4840
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Country | US
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Telephone | 972-841-9171
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 202859
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License Number State | TX
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