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General NPI Number Information
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NPI Number | 1467817346
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Entity Type | Organization
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Legal Business Name | KRISTIN KOBERSTEIN
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 243 CENTER ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-2101
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Country | US
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Telephone | 585-397-5012
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Fax |
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Provider Business Mailing Address
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Address Line | 243 CENTER ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-2101
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Country | US
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Telephone | 585-397-5012
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | KRISTIN KOBERSTEIN
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Credential | MA, LMFT
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Telephone | 585-397-5012
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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 | 001025-1
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License Number State | NY
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