Provider Demographics
NPI:1841927324
Name:HUCKS, KRYSTYN SHANEE (LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KRYSTYN
Middle Name:SHANEE
Last Name:HUCKS
Suffix:
Gender:F
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:SHANEE
Other - Middle Name:
Other - Last Name:HUCKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT-ASSOCIATE
Mailing Address - Street 1:111 E UNIVERSITY DR., STE 105 PMB 171
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209
Mailing Address - Country:US
Mailing Address - Phone:940-202-9292
Mailing Address - Fax:
Practice Address - Street 1:401 AME DR APT 5301
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-7688
Practice Address - Country:US
Practice Address - Phone:940-202-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204625106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist