Doten, Kristine A
Doten, Kristine A is an sole proprietor health care provider with primary practice located at 11292 86Th Ave N Ste 106 , Maple Grove MN 55369-4510. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Doten, Kristine A can be contacted via phone (952) 300-5908.Contact Information
Primary practice address
11292 86Th Ave N Ste 106
Maple Grove MN 55369-4510
Phone: (952) 300-5908
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 01687 | Minnesota |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | CC01429 | Minnesota |
Profile Details
NPI number | 1700284452 |
---|---|
LBN Legal business name | Doten, Kristine A |
Credentials | MA, LPCC |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 11th, 2014 |
Last updated | Jun 21st, 2017 - about 7 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700284452 | NPPES |
Minnesota | MEDICAID | 637688900 |
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