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Individual
KRISTIE LYNN SPOONER
Active
Individual
KRISTIE LYNN SPOONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, LSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1358
ND
104100000X
Social Worker
2163
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011580
BCBS PROVIDER NUMBER
ND
Enumeration date
08/21/2006
Last updated
11/16/2017
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