MEDICARE: MS. KRISTEN BIRD M.S.

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
1	106H00000X	Marriage & Family Therapist	52098	CA
2	106H00000X	Marriage & Family Therapist	1281	NC

General Provider Information

NPI Number	:	1366512188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN BIRD M.S.

Provider Business Mailing Address
First Line	:	826 TIMBER DR
Second Line	:
City	:	GARNER
State	:	NC
Zip	:	27529-4850
Country	:	US
Telephone Number	:	984-242-0291
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 TIMBER DR
Second Line	:
City	:	GARNER
State	:	NC
Zip	:	27529-4850
Country	:	US
Telephone Number	:	984-242-0291
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	11/27/2024

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