Provider Demographics
NPI:1124569850
Name:DOAN, KRISTIN (MA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:HAUSWIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10435 MIDTOWN PKWY
Mailing Address - Street 2:UNIT 165
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246
Mailing Address - Country:US
Mailing Address - Phone:703-771-5100
Mailing Address - Fax:703-777-0170
Practice Address - Street 1:20276 TIMBERLAKE RD
Practice Address - Street 2:SUITE A
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502
Practice Address - Country:US
Practice Address - Phone:434-319-5528
Practice Address - Fax:703-777-0170
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health