Provider Demographics
NPI:1194356717
Name:SAGUN, KRISTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:SAGUN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 NATIONAL DRIVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866
Mailing Address - Country:US
Mailing Address - Phone:410-353-3243
Mailing Address - Fax:
Practice Address - Street 1:3901 NATIONAL DRIVE
Practice Address - Street 2:SUITE #100
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866
Practice Address - Country:US
Practice Address - Phone:410-353-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04832103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling