Provider Demographics
NPI:1538670096
Name:PACE, KRISTI ORGILL
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:ORGILL
Last Name:PACE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S GIBSON RD APT 622
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2670
Mailing Address - Country:US
Mailing Address - Phone:808-294-5752
Mailing Address - Fax:
Practice Address - Street 1:111 S GIBSON RD APT 622
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-2670
Practice Address - Country:US
Practice Address - Phone:808-294-5752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor