Provider Information for 1538478003
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Ms. KRISTINA GRACE HUDDLESTON MS, LMFT
Sex: Female
NPI: 1538478003
Last Updated: 2019-11-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1538478003 | ||||||||||||||||
| Enumeration Date | 2010-10-01 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 3037 AUSTIN PALE AVE NORTH LAS VEGAS, NV 89081-6406 United States Phone: 702-600-1519 | Fax: | ||||||||||||||||
| Primary Practice Address | 3220 TAYLOR AVE NORTH LAS VEGAS, NV 89030-7262 United States Phone: 702-466-8107 | Fax: | ||||||||||||||||
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