Provider Demographics
NPI:1083392047
Name:DUCOTE, KRISTINE MARIE
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:DUCOTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2764 COMPASS DR STE 243
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8735
Mailing Address - Country:US
Mailing Address - Phone:970-462-5890
Mailing Address - Fax:
Practice Address - Street 1:2708 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-4031
Practice Address - Country:US
Practice Address - Phone:970-243-9539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health