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General NPI Number Information
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NPI Number | 1366907545
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Entity Type | Organization
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Legal Business Name | KAREN J. KIETZMAN. PSY.D., INC.
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 2475 VILLAGE LN STE 104
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City | BILLINGS
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State | MT
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Zip | 59102-2497
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Country | US
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Telephone | 406-248-4153
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Fax |
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Provider Business Mailing Address
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Address Line | 2475 VILLAGE LN STE 104
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City | BILLINGS
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State | MT
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Zip | 59102-2497
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Country | US
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Telephone | 406-248-4153
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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. KAREN J. KIETZMAN
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Credential | PSY.D.
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Telephone | 406-248-4153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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