# DR. KRISTIN ANN KULLGREN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1396765327
- **Gender:** F
- **Credential:** PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 2000175012 | MO | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 6301014861 | MI | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 11/25/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 139879 | BCBS | — |
| 01 | — | 227926 | UBH | — |
| 05 | — | 495201402 | — | MO |