Basic Information
| Provider Information | |||||||||
| NPI: | 1679151229 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIVERA TINGKANG | ||||||||
| FirstName: | CRISTY | ||||||||
| MiddleName: | NAPUAOKALANI | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 406 E GEMINI LN | ||||||||
| Address2: | |||||||||
| City: | KILLEEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765423071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8087292767 | ||||||||
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| Practice Location | |||||||||
| Address1: | 775 INDIAN TRL STE 200 | ||||||||
| Address2: | |||||||||
| City: | HARKER HEIGHTS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765487026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778005722 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2021 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 82531 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.