Dahl, Kristin Beth

Dahl, Kristin Beth is an individual health care provider with primary practice located at 11280 86Th Ave N , Maple Grove MN 55369-4510. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dahl, Kristin Beth can be contacted via phone (763) 400-7828.

Contact Information

Primary practice address
11280 86Th Ave N Maple Grove MN 55369-4510
Phone: (763) 400-7828
Fax: (763) 400-7444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 5289 Minnesota

Profile Details

NPI number 1134382914
LBN Legal business name Dahl, Kristin Beth
Credentials PSYD, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2008
Last updated May 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134382914 NPPES
Minnesota Other H400136351 MEDICARE PTAN
Minnesota MEDICAID 393603200 MEDICARE PTAN

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