Provider Demographics
NPI:1942252036
Name:KORINKO, KRISTIN J (LMHC/BCBA)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:J
Last Name:KORINKO
Suffix:
Gender:F
Credentials:LMHC/BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 JOHN KNOX RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6609
Mailing Address - Country:US
Mailing Address - Phone:850-385-0053
Mailing Address - Fax:
Practice Address - Street 1:220 JOHN KNOX RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6609
Practice Address - Country:US
Practice Address - Phone:850-385-0053
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 3719101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor