Provider Demographics
NPI:1275271421
Name:HILL, KRISTINA LYNN (BA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:KRISTINA
Other - Middle Name:LYNN
Other - Last Name:WENTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:161 GAITHER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1740
Mailing Address - Country:US
Mailing Address - Phone:856-579-9631
Mailing Address - Fax:
Practice Address - Street 1:161 GAITHER DR STE 105
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1740
Practice Address - Country:US
Practice Address - Phone:856-579-9631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health