Healthcare Provider Details

I. General information

NPI: 1083759336
Provider Name (Legal Business Name): KRISTIN PERRONE PH.D., H.S.P.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 W PURDUE AVE
MUNCIE IN
47304-6356
US

IV. Provider business mailing address

10629 KENSINGTON LN
FORTVILLE IN
46040-8900
US

V. Phone/Fax

Practice location:
  • Phone: 765-284-0043
  • Fax:
Mailing address:
  • Phone: 317-441-6687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number20041593A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: