Provider Demographics
NPI:1063878122
Name:DOE, KRISTEN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:DOE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 E SPEEDWAY BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-4724
Mailing Address - Country:US
Mailing Address - Phone:520-306-0660
Mailing Address - Fax:
Practice Address - Street 1:2030 E SPEEDWAY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-4724
Practice Address - Country:US
Practice Address - Phone:520-306-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15852101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional