Provider Demographics
NPI:1811329451
Name:FLOYD, KRISTEN (CMCH)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:CMCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 24TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-2580
Mailing Address - Country:US
Mailing Address - Phone:801-399-1818
Mailing Address - Fax:801-782-8412
Practice Address - Street 1:707 24TH ST
Practice Address - Street 2:STE D
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2580
Practice Address - Country:US
Practice Address - Phone:801-399-1818
Practice Address - Fax:801-782-8412
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health