Krietsch, Kelly
Krietsch, Kelly is an individual health care provider with primary practice located at 2935 Southwest Dr , Sedona AZ 86336-3797. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Krietsch, Kelly can be contacted via phone (928) 203-4844.Contact Information
Primary practice address
2935 Southwest Dr
Sedona AZ 86336-3797
Phone: (928) 203-4844
Fax: (928) 203-4497
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1554 | Arizona |
Profile Details
| NPI number | 1497880116 |
|---|---|
| LBN Legal business name | Krietsch, Kelly |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Jan 21st, 2009 - about 16 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 | 1497880116 | NPPES |
| Arizona | MEDICAID | 12364601 | |
| Arizona | Other | AZ0614590 |
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