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Individual

MS. KRISTI L KUNTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC, LSW

Contact information

Practice address
151 S 4TH ST, SUITE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3050
Mailing address
151 S 4TH ST, SUITE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3050

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1347
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
018088
BCBS ND PROVIDER NUMBER
ND
05
054519
ND
01
48B82KU
BCBS MN PROVIDER NUMBER
MN
Enumeration date
07/07/2006
Last updated
07/09/2007
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