Provider Demographics
NPI:1902341795
Name:WILLIAMS, KRISTY (MS)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6728 PARK VISTA BLVD APT 3402
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76137-4783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6728 PARK VISTA BLVD APT 3402
Practice Address - Street 2:
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76137-4783
Practice Address - Country:US
Practice Address - Phone:601-324-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88326101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health