Provider Demographics
NPI:1891058301
Name:RICHARDS, KRISTI S (LMT)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:S
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 YMCA DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5242
Mailing Address - Country:US
Mailing Address - Phone:972-268-7030
Mailing Address - Fax:
Practice Address - Street 1:206 YMCA DR
Practice Address - Street 2:SUITE 103
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5242
Practice Address - Country:US
Practice Address - Phone:972-268-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist