Provider Demographics
NPI:1700041811
Name:HYATT, KRISTI ANN (MS, LCPC)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:ANN
Last Name:HYATT
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:
Other - Last Name:SIMPFENDERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10662
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59719-0662
Mailing Address - Country:US
Mailing Address - Phone:406-581-8804
Mailing Address - Fax:
Practice Address - Street 1:2023 STADIUM DR STE 2B
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-0613
Practice Address - Country:US
Practice Address - Phone:406-581-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional