Provider Demographics
NPI:1609043876
Name:WAMPLER, KARI LYN (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:LYN
Last Name:WAMPLER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7092 POLARIS LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-3223
Mailing Address - Country:US
Mailing Address - Phone:763-420-5474
Mailing Address - Fax:
Practice Address - Street 1:244 LAKE ST N
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2517
Practice Address - Country:US
Practice Address - Phone:651-464-3685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health