Provider Demographics
NPI:1932330388
Name:BEYER, KRISTEN RALPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:RALPH
Last Name:BEYER
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 1:1562 HUNTERS LAKE CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-3250
Mailing Address - Country:US
Mailing Address - Phone:540-419-7614
Mailing Address - Fax:
Practice Address - Street 1:27600 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3348
Practice Address - Country:US
Practice Address - Phone:540-419-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009882)103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical