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General NPI Number Information
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NPI Number | 1609321603
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Entity Type | Individual
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Provider Name | MS. KRISTINA NICOLE DURENE
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Gender | Female
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 17350 STATE HIGHWAY 249 STE 220
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City | HOUSTON
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State | TX
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Zip | 77064-1132
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Country | US
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Telephone | 253-527-7783
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Fax |
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Provider Business Mailing Address
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Address Line | 6420 HEATHER DR
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City | WATAUGA
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State | TX
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Zip | 76148-1715
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Country | US
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Telephone | 612-384-6305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60922020
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 93379
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License Number State | TX
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