Provider Demographics
NPI:1972876092
Name:KAMPS, CRISTI LYNN (MA)
Entity type:Individual
Prefix:
First Name:CRISTI
Middle Name:LYNN
Last Name:KAMPS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3644 GENERAL MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-3664
Mailing Address - Country:US
Mailing Address - Phone:386-316-8797
Mailing Address - Fax:
Practice Address - Street 1:1011 W INTERNATIONAL SPEEDWAY BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3421
Practice Address - Country:US
Practice Address - Phone:386-238-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor