Provider Demographics
NPI:1225337876
Name:WELKER, KRISTINA DIANE (PSYD, LPC)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:DIANE
Last Name:WELKER
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Gender:F
Credentials:PSYD, LPC
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Mailing Address - Street 1:12020 S WARNER ELLIOT LOOP
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-2700
Mailing Address - Country:US
Mailing Address - Phone:480-893-6767
Mailing Address - Fax:480-730-9342
Practice Address - Street 1:12020 S WARNER ELLIOT LOOP
Practice Address - Street 2:SUITE 104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-2700
Practice Address - Country:US
Practice Address - Phone:480-893-6767
Practice Address - Fax:480-730-9342
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2011-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ12456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional