Provider Demographics
NPI:1467851154
Name:GERPE, KRISTEN (EDS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:GERPE
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 CLEVELAND RD E
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-1871
Mailing Address - Country:US
Mailing Address - Phone:418-432-1234
Mailing Address - Fax:
Practice Address - Street 1:712 CLEVELAND RD E
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:OH
Practice Address - Zip Code:44839-1871
Practice Address - Country:US
Practice Address - Phone:419-432-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3192266103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool