Individual
MR. KRIS GEORGE RADKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.C., M.A.T.
Contact information
Practice address
1510 E FLOWER ST, PHOENIX, AZ 85014-5656
(602) 530-6970
Mailing address
6913 W MONONA DR, GLENDALE, AZ 85308-8983
(623) 261-8558
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-0186
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-0186
LICENSE FOR PROFESSIONAL COUNSELOR
AZ
Enumeration date
11/18/2008
Last updated
11/18/2008
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