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General NPI Number Information
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NPI Number | 1235534322
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Entity Type | Organization
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Legal Business Name | DR. KRISTEN HUSTED
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 208 PARSONS LN
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2846
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Country | US
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Telephone | 906-332-6595
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Fax |
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Provider Business Mailing Address
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Address Line | 29434 E SOMES RD
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City | DRUMMOND ISLAND
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State | MI
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Zip | 49726-9593
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Country | US
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Telephone | 906-332-6595
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTEN HUSTED
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Credential | PHD
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Telephone | 906-332-6595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801086548
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License Number State | MI
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