Provider Demographics
NPI:1548753320
Name:ARB, KRISTINA (BS, LAC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:
Last Name:ARB
Suffix:
Gender:F
Credentials:BS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 RICHARDS DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-1724
Mailing Address - Country:US
Mailing Address - Phone:913-248-1943
Mailing Address - Fax:913-248-1994
Practice Address - Street 1:12510 W 62ND TER STE 109
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-1869
Practice Address - Country:US
Practice Address - Phone:913-766-1587
Practice Address - Fax:913-766-1668
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1548101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)