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General NPI Number Information
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NPI Number | 1841927324
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Entity Type | Individual
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Provider Name | KRYSTYN SHANEE HUCKS LMFT-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 08/04/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 401 AME DR APT 5301
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City | DENTON
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State | TX
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Zip | 76207-7688
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Country | US
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Telephone | 940-202-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 111 E UNIVERSITY DR., STE 105 PMB 171
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City | DENTON
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State | TX
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Zip | 76209
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Country | US
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Telephone | 940-202-9292
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 204625
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License Number State | TX
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