Provider Demographics
NPI:1568892370
Name:KISSINGFORD, KATHARINE (MFT)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:
Last Name:KISSINGFORD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1285
Mailing Address - Street 2:
Mailing Address - City:OURAY
Mailing Address - State:CO
Mailing Address - Zip Code:81427-1285
Mailing Address - Country:US
Mailing Address - Phone:303-949-2642
Mailing Address - Fax:
Practice Address - Street 1:160 S AMELIA ST
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:CO
Practice Address - Zip Code:81432-9518
Practice Address - Country:US
Practice Address - Phone:720-722-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0013392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist