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NPI Code Detail

MEDICARE: KRISTEN RAE DOLF

MEDICARE: KRISTEN RAE DOLF
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1275774218
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN RAE DOLF
Provider Business Mailing Address
First Line : 1324 NW 184TH ST
Second Line :
City : EDMOND
State : OK
Zip : 73012-4024
Country : US
Telephone Number : 405-613-3309
Fax Number :
Provider Business Practice Location Address
First Line : 7777 E US HIGHWAY 66
Second Line :
City : EL RENO
State : OK
Zip : 73036-9125
Country : US
Telephone Number : 405-422-8803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2009
Last Update Date : 03/22/2009

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Directions to “ KRISTEN RAE DOLF ” Practice Location

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