Provider Demographics
NPI:1831428655
Name:GUNSAULUS-MUSICK, KRISTINE L (PHD)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:L
Last Name:GUNSAULUS-MUSICK
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:PO BOX 2513
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-2513
Mailing Address - Country:US
Mailing Address - Phone:970-586-6767
Mailing Address - Fax:870-586-5133
Practice Address - Street 1:356 E. ELKHORN AVE.
Practice Address - Street 2:UNIT 9
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-2513
Practice Address - Country:US
Practice Address - Phone:970-586-6767
Practice Address - Fax:970-586-5133
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1777101YP2500X
CO2863103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional