Individual
DR. KAREN JOHNSON KIETZMAN
Active
Individual
DR. KAREN JOHNSON KIETZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
273
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0493337
—
MT
01
—
104140
NEW WEST HEALTH SERVICES
MT
01
—
141721
VALUEOPTIONS
MT
01
—
50931
BLUE CROSS BLUE SHEILD
MT
Enumeration date
08/12/2006
Last updated
02/07/2025
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