Individual
DR. KRISTINE LYNN BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
110 E MAIN ST, VERMILLION, SD 57069-2201
(605) 624-9307
(605) 624-9308
Mailing address
110 E MAIN ST, P.O. BOX 283, VERMILLION, SD 57069-2201
(605) 624-9307
(605) 624-9308
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
455
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28205
SIOUX VALLEY HEALTH PLAN
SD
01
—
455
DAKOTACARE
SD
01
—
4995005
BLUE CROSS/BLUE SHIELD
SD
05
—
6552222
—
SD
Enumeration date
11/07/2005
Last updated
01/24/2008
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