Edstrom, Kristine Lee

Edstrom, Kristine Lee is an individual health care provider with primary practice located at 504 S 2Nd Ave , Virginia MN 55792. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Edstrom, Kristine Lee can be contacted via phone (218) 212-5700.

Contact Information

Primary practice address
504 S 2Nd Ave Virginia MN 55792
Phone: (218) 212-5700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2875 Minnesota

Profile Details

NPI number 1225679053
LBN Legal business name Edstrom, Kristine Lee
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2019
Last updated May 31st, 2022 - about 2 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 1225679053 NPPES
Minnesota Other 2875 MN BOARD OF BEHAVIORAL HEALTH AND THERAPY

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