Provider Demographics
NPI:1487703021
Name:HAINES, KRISTINA ELIZABETH (LMHC)
Entity type:Individual
Prefix:MISS
First Name:KRISTINA
Middle Name:ELIZABETH
Last Name:HAINES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 SE 59TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-7745
Mailing Address - Country:US
Mailing Address - Phone:352-843-0227
Mailing Address - Fax:352-671-7379
Practice Address - Street 1:4300 SE 59TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-7745
Practice Address - Country:US
Practice Address - Phone:352-843-0227
Practice Address - Fax:352-671-7379
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7621101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional