Provider Demographics
NPI:1861121394
Name:KRISTY STITH THERAPY
Entity type:Organization
Organization Name:KRISTY STITH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DI
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:STITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-872-7974
Mailing Address - Street 1:525 LANGLEY TRCE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-6742
Mailing Address - Country:US
Mailing Address - Phone:270-872-7974
Mailing Address - Fax:
Practice Address - Street 1:525 LANGLEY TRCE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-6742
Practice Address - Country:US
Practice Address - Phone:270-872-7974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency