Provider Demographics
NPI:1659721629
Name:GARAY, KRISTY DILLENIA
Entity Type:Individual
Prefix:MISS
First Name:KRISTY
Middle Name:DILLENIA
Last Name:GARAY
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 1:93 PARRISH LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-4826
Mailing Address - Country:US
Mailing Address - Phone:702-353-6565
Mailing Address - Fax:
Practice Address - Street 1:93 PARRISH LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-4826
Practice Address - Country:US
Practice Address - Phone:702-353-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health