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General NPI Number Information
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NPI Number | 1831102508
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Entity Type | Individual
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Provider Name | KRISTIE L PUSTER PHD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 6535 NEMOURS PKWY
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City | ORLANDO
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State | FL
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Zip | 32827-7884
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Country | US
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Telephone | 407-567-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2207 SETTLERS TRL
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City | ORLANDO
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State | FL
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Zip | 32837-6967
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Country | US
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Telephone | 401-573-3416
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS01332
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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