Individual provider · NPI-1

Kristen Noel Bast, LMLP-T

Psychologist, Clinical · Lawrence, KS

NPI number1124229927
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1124229927
Entity type
Individual (NPI-1)
Name
Kristen Noel Bast
Credential
LMLP-T
Sex
Female
Sole proprietor
No
Enumeration date
May 30, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical1095KSYes

Practice location

200 Maine St Ste A
Lawrence, KS 66044-1396

Phone 785-843-9192 · Fax 785-843-6744

Mailing address

200 Maine St Ste A
Lawrence, KS 66044-1396

Phone 785-843-9192 · Fax 785-843-6744

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