Provider Demographics
NPI:1992271779
Name:BATZ, KRISTIE (MA, OMC)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:BATZ
Suffix:
Gender:F
Credentials:MA, OMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 893
Mailing Address - Street 2:
Mailing Address - City:GRAND MARAIS
Mailing Address - State:MN
Mailing Address - Zip Code:55604-0893
Mailing Address - Country:US
Mailing Address - Phone:218-590-0816
Mailing Address - Fax:
Practice Address - Street 1:ACCEND SERVICES
Practice Address - Street 2:101 W HWY 61
Practice Address - City:GRAND MARAIS
Practice Address - State:MN
Practice Address - Zip Code:55604
Practice Address - Country:US
Practice Address - Phone:218-590-0816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician