Provider Demographics
NPI:1104162882
Name:HARRIN, KRISTI M (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:M
Last Name:HARRIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13039 W LINEBAUGH AVE
Mailing Address - Street 2:BLDG V SUITE 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4483
Mailing Address - Country:US
Mailing Address - Phone:888-531-1313
Mailing Address - Fax:888-531-6035
Practice Address - Street 1:13039 W LINEBAUGH AVE
Practice Address - Street 2:BLDG V SUITE 101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4483
Practice Address - Country:US
Practice Address - Phone:888-531-1313
Practice Address - Fax:888-531-6035
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-27
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8676103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical