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General NPI Number Information
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NPI Number | 1497232912
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Entity Type | Individual
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Provider Name | KRISTEN CONKLIN FLANK
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Gender | Female
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 304 E PENNSYLVANIA AVE
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City | TOWSON
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State | MD
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Zip | 21286-5369
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Country | US
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Telephone | 410-371-0247
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SUNSET KNOLL CT
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City | LUTHERVILLE
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State | MD
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Zip | 21093-4775
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Country | US
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Telephone | 410-371-0257
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC8745
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License Number State | MD
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