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General NPI Number Information
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NPI Number | 1144644709
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Entity Type | Individual
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Provider Name | KRYSTLE KAYLEE KREIDER LPCC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 2875 TINA AVE STE 106
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City | MISSOULA
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State | MT
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Zip | 59808-1582
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Country | US
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Telephone | 406-552-3587
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Fax |
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Provider Business Mailing Address
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Address Line | 6315 LONE MOOSE CT
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City | FLORENCE
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State | MT
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Zip | 59833-6005
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Country | US
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Telephone | 505-977-5376
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0181471
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | BBH-LCPC-LIC-43090
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License Number State | MT
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