Provider Demographics
NPI:1508642877
Name:DRAUGHN, KIRISTEN LEIGH (MPS)
Entity Type:Individual
Prefix:
First Name:KIRISTEN
Middle Name:LEIGH
Last Name:DRAUGHN
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9475 DEERECO RD STE 410
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2124
Mailing Address - Country:US
Mailing Address - Phone:410-560-6135
Mailing Address - Fax:410-560-6136
Practice Address - Street 1:9475 DEERECO RD STE 410
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2124
Practice Address - Country:US
Practice Address - Phone:410-560-6135
Practice Address - Fax:410-560-6136
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0896101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor