Provider Demographics
NPI:1720304934
Name:HIRSH, KRISTEN YANCHAK (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:YANCHAK
Last Name:HIRSH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 WHITESPORT CIR SW STE 2
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6443
Mailing Address - Country:US
Mailing Address - Phone:256-533-9393
Mailing Address - Fax:256-533-9690
Practice Address - Street 1:4800 WHITESPORT CIR SW STE 2
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6443
Practice Address - Country:US
Practice Address - Phone:256-533-9393
Practice Address - Fax:256-533-9690
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1602103TC1900X
TNP0000002896103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent