Individual
DR. KRISTIN M VENABLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 588-0661
(763) 302-4345
Mailing address
4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4215
(763) 588-0661
(763) 302-4345
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
LP5885
MN
103T00000X
Psychologist
PY8956
FL
103TC0700X
Clinical Psychologist
Primary
LP5885
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP5885
MEDICAL LICENSE
MN
01
—
PSY003569
MEDICAL LICENSE
GA
Enumeration date
05/29/2012
Last updated
09/05/2024
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