Provider Demographics
NPI:1922778802
Name:DRUHE, KRISTINA (RMFTI, RMHCI)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:DRUHE
Suffix:
Gender:F
Credentials:RMFTI, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2349 MAX CT
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-3699
Mailing Address - Country:US
Mailing Address - Phone:951-541-7702
Mailing Address - Fax:
Practice Address - Street 1:2759 STATE ROAD 580 STE 112
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3352
Practice Address - Country:US
Practice Address - Phone:727-351-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT3572106H00000X
IMH21542101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty