Organization
KRISTIN S. KILDAHL, MA, LP, LLC
Active
Organization
KRISTIN S. KILDAHL, MA, LP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTIN SKOOG KILDAHL MA, LP (PSYCHOLOGIST)
(612) 272-5107
Entity
Organization
Contact information
Practice address
7200 FRANCE AVE S, EDINA, MN 55435-4300
(612) 272-5107
(651) 730-6657
Mailing address
9923 BROOKSIDE CIR, BLOOMINGTON, MN 55431-2826
(612) 272-5107
(651) 730-6657
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1384
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578643730
TYPE 1 NPI #
MN
05
—
1578643730
—
MN
Enumeration date
03/15/2010
Last updated
03/16/2010
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