Provider Demographics
NPI:1063557403
Name:DEVLIN, KIRSTEN MAY (LMFT)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MAY
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-6523
Mailing Address - Country:US
Mailing Address - Phone:253-961-3702
Mailing Address - Fax:253-752-1068
Practice Address - Street 1:1705 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-6523
Practice Address - Country:US
Practice Address - Phone:253-961-3702
Practice Address - Fax:253-752-1068
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist