Dr. Kristine Marie Vazzano, PhD
Psychologist, Clinical in Bloomfield Hills, MI. Individual provider (NPI-1).
NPI number1902932403
StatusActive
Last updated in NPPESJan 17, 2012
Details
- NPI
- 1902932403
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kristine Marie Vazzano
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2007
- Last updated
- Jan 17, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6301014012 | MI | Yes |
Other names
- Kristine Marie Tippen (Former Name)
Practice location
3910 Telegraph RdSuite 202
Bloomfield Hills, MI 48302-1420
Phone 248-686-0346 · Fax 248-686-0344
Mailing address
3910 Telegraph RdSuite 202
Bloomfield Hills, MI 48302-1420
Phone 248-686-0346 · Fax 248-686-0344
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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