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Individual
MS. KRISTINE JOY THORESEN
Active
Individual
MS. KRISTINE JOY THORESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, DCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1015859
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007775
PACIFIC CARE PROVIDER #
MA
01
—
008278
VALUE OPTIONS PROVIDER #
MA
01
—
1891910
MBHP PROVIDER NUMBER
MA
01
—
358812
MAGELLAN PROVIDER NUMBER
MA
01
—
760845
TUFTS PROVIDER NUMBER
MA
01
—
PO4675
BC BS PROVIDER NUMBER
MA
Enumeration date
02/07/2007
Last updated
07/08/2007
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