Provider Demographics
NPI:1356683270
Name:THOMAS, KRISTEN FUHRMAN (MSED, CMHC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:FUHRMAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSED, CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 E 4500 S
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4519
Mailing Address - Country:US
Mailing Address - Phone:840-466-1381
Mailing Address - Fax:
Practice Address - Street 1:4625 S 2300 E
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-4583
Practice Address - Country:US
Practice Address - Phone:801-865-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-732101Y00000X
UT12917173-6004101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor