Provider Demographics
NPI:1770354193
Name:PINSON, KRISTIE (RDH, BSDH, OMT)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:PINSON
Suffix:
Gender:F
Credentials:RDH, BSDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:PERRYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79070-5735
Mailing Address - Country:US
Mailing Address - Phone:806-202-8930
Mailing Address - Fax:
Practice Address - Street 1:2101 VALLEJO ST
Practice Address - Street 2:
Practice Address - City:PERRYTON
Practice Address - State:TX
Practice Address - Zip Code:79070-5735
Practice Address - Country:US
Practice Address - Phone:806-202-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach