Provider Demographics
NPI:1205679222
Name:FERRIS, KRISTIN (BSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:FERRIS
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 PIERING DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-5682
Mailing Address - Country:US
Mailing Address - Phone:770-545-4748
Mailing Address - Fax:
Practice Address - Street 1:2516 PIERING DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-5682
Practice Address - Country:US
Practice Address - Phone:770-545-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare