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Provider Information for 1245824457


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KRISSANDRA CHERRIA HAYNES LPC


Sex: Female

NPI: 1245824457
Last Updated: 2021-02-28
Certification Date: 2021-02-28

Details

NameValue
NPI1245824457
Enumeration Date2021-02-28
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 115 CRESTBROOK DR
ROCKWALL, TX 75087-7131
United States

Phone: 770-298-3558 | Fax:
 
Primary Practice Address 7290 VIRGINIA PKWY
MCKINNEY, TX 75071-5740
United States

Phone: 469-808-1016 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalTX81998