Basic Information
| Provider Information | |||||||||
| NPI: | 1720304934 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIRSH | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | YANCHAK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 WHITESPORT CIR SW STE 2 | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358016443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565339393 | ||||||||
| FaxNumber: | 2565339690 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 WHITESPORT CIR SW STE 2 | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358016443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565339393 | ||||||||
| FaxNumber: | 2565339690 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2010 | ||||||||
| LastUpdateDate: | 10/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC1900X | 1602 | AL | Y | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.