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General NPI Number Information
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NPI Number | 1972807527
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Entity Type | Organization
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Legal Business Name | KRISTIN P. GIRARDOT, PH.D, LLC
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 500 N MAITLAND AVE SUITE 110
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City | MAITLAND
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State | FL
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Zip | 32751-4482
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Country | US
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Telephone | 407-808-7852
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 547878
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City | ORLANDO
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State | FL
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Zip | 32854-7878
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Country | US
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Telephone | 407-808-7852
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KRISTIN P. GIRARDOT
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Credential | PH.D
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Telephone | 407-808-7852
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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 |
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License Number State |
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