Provider Demographics
NPI:1407049737
Name:WILHELMSEN, KRISTINE LEE (BA)
Entity Type:Individual
Prefix:MISS
First Name:KRISTINE
Middle Name:LEE
Last Name:WILHELMSEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:703 OCEAN MDWS
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5232
Mailing Address - Country:US
Mailing Address - Phone:774-634-9251
Mailing Address - Fax:508-993-1162
Practice Address - Street 1:4 HARTWELL ST
Practice Address - Street 2:STE 307
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3019
Practice Address - Country:US
Practice Address - Phone:774-634-9251
Practice Address - Fax:508-993-1162
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2016-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical