Provider Demographics
NPI:1912908237
Name:DELARWELLE, KRISTI MARIE (PT)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:MARIE
Last Name:DELARWELLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:MARIE
Other - Last Name:BARRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7250 FRANCE AVENUE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4305
Mailing Address - Country:US
Mailing Address - Phone:952-285-2840
Mailing Address - Fax:952-285-2830
Practice Address - Street 1:9220 BASS LAKE ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428
Practice Address - Country:US
Practice Address - Phone:763-533-0363
Practice Address - Fax:763-533-0842
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist