Provider Demographics
NPI:1629523501
Name:POEHNER, KRISTYN NOELLE
Entity Type:Individual
Prefix:MISS
First Name:KRISTYN
Middle Name:NOELLE
Last Name:POEHNER
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 1:995 HELLING WAY
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-8619
Mailing Address - Country:US
Mailing Address - Phone:530-265-7222
Mailing Address - Fax:
Practice Address - Street 1:995 HELLING WAY
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-8619
Practice Address - Country:US
Practice Address - Phone:530-265-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health