Provider Demographics
NPI:1518791912
Name:BOXX, KRISTI
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:BOXX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 BOWIE DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-8351
Mailing Address - Country:US
Mailing Address - Phone:662-614-0537
Mailing Address - Fax:
Practice Address - Street 1:304 ENTERPRISE DR STE C
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-2762
Practice Address - Country:US
Practice Address - Phone:662-638-3538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-1195101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor