Provider Demographics
NPI:1245014307
Name:BIERWIRTH, KRISTEN PETERS (PHD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:PETERS
Last Name:BIERWIRTH
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 1:35 TAGGART CT
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1085
Mailing Address - Country:US
Mailing Address - Phone:646-391-4470
Mailing Address - Fax:
Practice Address - Street 1:1485 S COUNTY TRL STE 107
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1747
Practice Address - Country:US
Practice Address - Phone:401-733-3349
Practice Address - Fax:401-941-7847
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool