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General NPI Number Information
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NPI Number | 1932589462
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Entity Type | Individual
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Provider Name | KRISTA JEAN CAIN MA, MPH, LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 7758 WALLACE RD STE VI
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 407-205-2574
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Fax |
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Provider Business Mailing Address
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Address Line | 515 PUERTA CT
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6822
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Country | US
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Telephone | 407-205-2574
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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 | MH15095
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License Number State | FL
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