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NPI Code Detail

MEDICARE: MS. KRISTINE MARIE BORN MA

MEDICARE: MS. KRISTINE MARIE BORN MA
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
1101YP2500XProfessional Counselor11401SC

General Provider Information

NPI Number : 1437465895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTINE MARIE BORN MA
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 843-501-1099
Fax Number : 843-405-2040
Provider Business Practice Location Address
First Line : 871 LOWCOUNTRY BLVD
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3066
Country : US
Telephone Number : 843-501-1099
Fax Number : 843-405-2040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2010
Last Update Date : 04/03/2026

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