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General NPI Number Information
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NPI Number | 1134528243
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Entity Type | Individual
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Provider Name | KIRSTEN TRYGG
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Gender | Female
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 1432 GRAND AVENUE
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601
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Country | US
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Telephone | 617-755-8889
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Fax | 970-827-4118
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | MINTURN
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State | CO
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Zip | 81645-0386
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Country | US
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Telephone | 617-755-8889
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Fax | 970-827-4118
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACA.0007011
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License Number State | CO
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