Provider Demographics
NPI:1760799589
Name:SAUTER, KRISTY ANN (LSW)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:ANN
Last Name:SAUTER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 JASPER BLUFF ST UNIT 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5977
Mailing Address - Country:US
Mailing Address - Phone:702-327-2829
Mailing Address - Fax:
Practice Address - Street 1:2152 JASPER BLUFF ST UNIT 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5977
Practice Address - Country:US
Practice Address - Phone:702-327-2829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2944-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker