Provider Demographics
NPI:1336892413
Name:BUNT, KRISTYN DANIELLE (MS)
Entity Type:Individual
Prefix:MS
First Name:KRISTYN
Middle Name:DANIELLE
Last Name:BUNT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 ADDISON CIR APT 2830
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6685
Mailing Address - Country:US
Mailing Address - Phone:254-396-0348
Mailing Address - Fax:
Practice Address - Street 1:5085 W PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2000
Practice Address - Country:US
Practice Address - Phone:972-665-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician