Provider Demographics
NPI:1659628428
Name:DOVER, KRISTINA (BSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:
Last Name:DOVER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WESTWOOD TER N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8325
Mailing Address - Country:US
Mailing Address - Phone:727-686-3494
Mailing Address - Fax:727-347-1649
Practice Address - Street 1:45 WESTWOOD TER N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8325
Practice Address - Country:US
Practice Address - Phone:727-686-3494
Practice Address - Fax:727-347-1649
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator