Individual
KRISTIN L MOULTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2901 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4614
(253) 534-7000
(253) 534-7099
Mailing address
2901 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4614
(253) 534-7000
(253) 534-7099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60061570
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8952612
CRIME VICTIMS
WA
01
—
8952613
CRIME VICTIMS
WA
Enumeration date
06/12/2012
Last updated
09/13/2012
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