Provider Demographics
NPI:1841233244
Name:HASTEN, KRISTI (OT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:
Last Name:HASTEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2837
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-2837
Mailing Address - Country:US
Mailing Address - Phone:706-868-1707
Mailing Address - Fax:706-868-1351
Practice Address - Street 1:7013 EVANS TOWN CENTER BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-5130
Practice Address - Country:US
Practice Address - Phone:706-868-1707
Practice Address - Fax:706-868-1351
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003288225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist