Provider Demographics
NPI:1588161962
Name:CRONAN, KRISTI GAIL (MA, APC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:GAIL
Last Name:CRONAN
Suffix:
Gender:F
Credentials:MA, APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11675 CENTURY DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-8367
Mailing Address - Country:US
Mailing Address - Phone:678-740-3990
Mailing Address - Fax:470-299-2260
Practice Address - Street 1:11675 CENTURY DR UNIT C
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8367
Practice Address - Country:US
Practice Address - Phone:678-740-3990
Practice Address - Fax:470-299-2260
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005903101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional