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General NPI Number Information
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NPI Number | 1144306002
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Entity Type | Organization
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Legal Business Name | KRISTINE G. MUSICK, PH.D., LLC
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 356 E. ELKHORN AVE. UNIT 9
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City | ESTES PARK
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State | CO
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Zip | 80517-2513
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Country | US
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Telephone | 970-586-6767
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Fax | 970-586-5133
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Provider Business Mailing Address
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Address Line | PO BOX 2513
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City | ESTES PARK
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State | CO
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Zip | 80517-2513
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Country | US
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Telephone | 970-586-6767
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Fax | 970-586-5133
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRISTINE LYNN GUNSAULUS-MUSICK
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Credential | PH.D.
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Telephone | 970-586-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2863
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License Number State | CO
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