Provider Demographics
NPI:1073567145
Name:WHITING, CRISTIN CARR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIN
Middle Name:CARR
Last Name:WHITING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2716
Mailing Address - Country:US
Mailing Address - Phone:336-723-0055
Mailing Address - Fax:336-723-0022
Practice Address - Street 1:632 HOLLY AVE
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2716
Practice Address - Country:US
Practice Address - Phone:336-723-0055
Practice Address - Fax:336-723-0022
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2938103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical