Provider Demographics
NPI:1114523289
Name:KOHN, KRISTINA MARGARET
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARGARET
Last Name:KOHN
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:PO BOX 542144
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-2144
Mailing Address - Country:US
Mailing Address - Phone:810-938-5321
Mailing Address - Fax:
Practice Address - Street 1:2107 BANKS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5303
Practice Address - Country:US
Practice Address - Phone:810-938-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX596721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical