Provider Demographics
NPI:1003385865
Name:PALMER, KRISTEN EMILY
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:EMILY
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:EMILY
Other - Last Name:GOLAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:134 W HOLUM ST
Mailing Address - Street 2:
Mailing Address - City:DEFOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-1108
Mailing Address - Country:US
Mailing Address - Phone:608-620-5126
Mailing Address - Fax:
Practice Address - Street 1:134 W HOLUM ST
Practice Address - Street 2:
Practice Address - City:DEFOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-1108
Practice Address - Country:US
Practice Address - Phone:608-415-3908
Practice Address - Fax:608-350-1288
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical