Provider Demographics
NPI:1508427204
Name:ROSENCRANS, KIRA MAY
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:MAY
Last Name:ROSENCRANS
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 1:1601 2ND AVE N STE 518
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3288
Mailing Address - Country:US
Mailing Address - Phone:406-799-2917
Mailing Address - Fax:
Practice Address - Street 1:1601 2ND AVE N STE 518
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3288
Practice Address - Country:US
Practice Address - Phone:406-799-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician