Provider Demographics
NPI:1386932721
Name:HUFFMAN, KRISTEN
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HUFFMAN
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 1:668 WEATHERVANE DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-7545
Mailing Address - Country:US
Mailing Address - Phone:931-212-4196
Mailing Address - Fax:
Practice Address - Street 1:7105 CROSSROADS BLVD.
Practice Address - Street 2:SUITE106
Practice Address - City:BRENTWODD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:UM
Practice Address - Phone:921-212-4196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-11-8369103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst