Provider Demographics
NPI:1629309430
Name:MALTAIS, KRISTA (ADPCD/PDT(DONA), ALC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:MALTAIS
Suffix:
Gender:F
Credentials:ADPCD/PDT(DONA), ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 LAFAYETTE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2206
Mailing Address - Country:US
Mailing Address - Phone:603-910-5497
Mailing Address - Fax:
Practice Address - Street 1:387 LAFAYETTE RD STE 209
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2206
Practice Address - Country:US
Practice Address - Phone:603-918-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No376J00000XNursing Service Related ProvidersHomemaker