Provider Demographics
NPI:1952919276
Name:O'BRIEN, KRISTIN LEAH (MA, LPA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEAH
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:LEAH
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16441 SPACE CENTER BLVD STE C-100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2015
Mailing Address - Country:US
Mailing Address - Phone:281-480-7554
Mailing Address - Fax:
Practice Address - Street 1:16441 SPACE CENTER BLVD STE C-100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2015
Practice Address - Country:US
Practice Address - Phone:281-480-7554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health