Provider Demographics
NPI:1235841966
Name:GARCIA, KRISTIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:CUPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:603 EMPIRE DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1437 DEKALB ST STE 100
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3440
Practice Address - Country:US
Practice Address - Phone:610-272-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018540103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical