Provider Demographics
NPI:1346530854
Name:KEDING, KRISTI LEE (LCMHC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LEE
Last Name:KEDING
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 GRANT AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-1845
Mailing Address - Country:US
Mailing Address - Phone:385-240-0689
Mailing Address - Fax:
Practice Address - Street 1:2351 GRANT AVE STE 202
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-1845
Practice Address - Country:US
Practice Address - Phone:385-240-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
UT8325421-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health