Provider Demographics
NPI:1871724211
Name:PAPIN, KRIS C (MA, LASAC)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:C
Last Name:PAPIN
Suffix:
Gender:F
Credentials:MA, LASAC
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:C
Other - Last Name:PAPIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LASAC
Mailing Address - Street 1:1301 W SECOND ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:AZ
Mailing Address - Zip Code:86047-3005
Mailing Address - Country:US
Mailing Address - Phone:928-289-2650
Mailing Address - Fax:928-289-0477
Practice Address - Street 1:1301 W SECOND ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:AZ
Practice Address - Zip Code:86047-3005
Practice Address - Country:US
Practice Address - Phone:928-289-2650
Practice Address - Fax:928-289-0477
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLASAC-13028101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)