Organization
KRIS KOESTNER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRIS KOESTNER LICSW (LICENSED CLINICAL SOCIAL WORKER)
(612) 798-7373
Entity
Organization
Contact information
Practice address
6607 18TH AVE S, RICHFIELD, MN 55423-2784
(612) 798-7373
Mailing address
6607 18TH AVE S, RICHFIELD, MN 55423-2784
(612) 798-7373
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
08765
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800002288
MEDICARE PTAN
MN
Enumeration date
06/15/2011
Last updated
06/15/2011
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