Provider Demographics
NPI:1053464206
Name:UNFRED, KRISTINA LEE (BACHELOR OF ARTS)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LEE
Last Name:UNFRED
Suffix:
Gender:F
Credentials:BACHELOR OF ARTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 W 13TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3986
Mailing Address - Country:US
Mailing Address - Phone:541-484-9894
Mailing Address - Fax:
Practice Address - Street 1:3692 HICKORY AVE.
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-284-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health