Provider Demographics
NPI:1134528243
Name:TRYGG, KIRSTEN
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:TRYGG
Suffix:
Gender:F
Credentials:
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 386
Mailing Address - Street 2:
Mailing Address - City:MINTURN
Mailing Address - State:CO
Mailing Address - Zip Code:81645-0386
Mailing Address - Country:US
Mailing Address - Phone:617-755-8889
Mailing Address - Fax:970-827-4118
Practice Address - Street 1:1432 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601
Practice Address - Country:US
Practice Address - Phone:617-755-8889
Practice Address - Fax:970-827-4118
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACA.0007011101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)