Provider Demographics
NPI:1588850010
Name:ROLLINS, KRISTEN BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:BETH
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:PHD
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 6161
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-6161
Mailing Address - Country:US
Mailing Address - Phone:207-653-2837
Mailing Address - Fax:
Practice Address - Street 1:367 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1350
Practice Address - Country:US
Practice Address - Phone:207-653-2837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS939103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist