Provider Demographics
NPI:1962834036
Name:WATSON, KRISTINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 SPRINGHURST BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6157
Mailing Address - Country:US
Mailing Address - Phone:502-807-9551
Mailing Address - Fax:
Practice Address - Street 1:4201 SPRINGHURST BLVD STE 203
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6157
Practice Address - Country:US
Practice Address - Phone:502-807-9551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist