Provider Demographics
NPI:1336935071
Name:BABCOCK, KRISTINE (BA)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:
Credentials:BA
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX G
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:VT
Mailing Address - Zip Code:05060-0167
Mailing Address - Country:US
Mailing Address - Phone:802-728-4466
Mailing Address - Fax:802-728-4197
Practice Address - Street 1:24 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:VT
Practice Address - Zip Code:05060-1369
Practice Address - Country:US
Practice Address - Phone:802-728-6000
Practice Address - Fax:802-728-5655
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator