Individual
MRS. KRISTY NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1617 HIGHWAY 12 E STE 230, WILLMAR, MN 56201-5816
(218) 791-8535
(320) 200-7480
Mailing address
PO BOX 284, WILLMAR, MN 56201-0284
(320) 218-7918
(320) 200-7480
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3059
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3059
LMFT LICENSE
MN
Enumeration date
10/24/2014
Last updated
02/20/2018
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