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General NPI Number Information
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NPI Number | 1205078268
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Entity Type | Organization
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Legal Business Name | KRISTIN KOBERSTEIN, LMFT, LLC
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 15 N MAIN ST 2ND FLOOR
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1974
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Country | US
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Telephone | 860-888-2752
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Fax |
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Provider Business Mailing Address
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Address Line | 200 REGAN RD 35 C
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City | VERNON
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State | CT
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Zip | 06066-2850
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Country | US
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Telephone | 860-428-4134
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | MRS. KRISTIN L KOBERSTEIN
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Credential | LMFT
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Telephone | 860-888-2752
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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 | 001242
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License Number State | CT
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