Provider Demographics
NPI:1912034828
Name:CORBETT, KRISTINA ROBERTS (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:ROBERTS
Last Name:CORBETT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KRISTINA
Other - Middle Name:KARIN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:705 W 7TH AVE
Mailing Address - Street 2:STE. 1 -C
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2806
Mailing Address - Country:US
Mailing Address - Phone:509-624-7252
Mailing Address - Fax:509-624-6442
Practice Address - Street 1:705 W 7TH AVE
Practice Address - Street 2:STE. 1 -C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2806
Practice Address - Country:US
Practice Address - Phone:509-624-7252
Practice Address - Fax:509-624-6442
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2481103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist