# KB COUNSELING EVALUATION MEDIATION SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609113083
- **Authorized official:** MS. KRISTI MARIE KAMISH-BUSHINSKI LMFT (DIRECTOR)
- **Authorized official phone:** (651) 303-0534

## Contact information

- **Practice address:** 6043 HUDSON RD, SUITE 140P, WOODBURY, MN 55125-1018
- **Practice address phone:** (651) 303-0534
- **Practice address fax:** (651) 337-7133
- **Mailing address:** 6043 HUDSON RD, SUITE 140P, WOODBURY, MN 55125-1018
- **Mailing address phone:** (651) 303-0534
- **Mailing address fax:** (651) 337-7133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 2068 | MN | Yes |

## Other

- **Enumeration date:** 01/06/2013
- **Last updated:** 01/06/2013