Healthcare Provider Details

I. General information

NPI: 1932019577
Provider Name (Legal Business Name): KRISTINA COURTLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 GLENDON CT
DUBLIN OH
43016-3246
US

IV. Provider business mailing address

PO BOX 200216
DALLAS TX
75320-0216
US

V. Phone/Fax

Practice location:
  • Phone: 877-641-2010
  • Fax:
Mailing address:
  • Phone: 877-641-2010
  • Fax: 855-643-0480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: