Provider Demographics
NPI:1730311911
Name:HABIBY, KRISTY MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:MARIE
Last Name:HABIBY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-9089
Mailing Address - Country:US
Mailing Address - Phone:317-718-0089
Mailing Address - Fax:317-718-0097
Practice Address - Street 1:3380 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-9089
Practice Address - Country:US
Practice Address - Phone:317-718-0089
Practice Address - Fax:317-718-0097
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010004A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics