Provider Demographics
NPI:1306731559
Name:TUBIN, KRISTINA SELMA
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:SELMA
Last Name:TUBIN
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 1:218 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2944
Mailing Address - Country:US
Mailing Address - Phone:914-462-0457
Mailing Address - Fax:
Practice Address - Street 1:6 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2161
Practice Address - Country:US
Practice Address - Phone:914-462-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health