Provider Demographics
NPI:1174734669
Name:CHRISTENSEN, KRISTA NOELLE (MA CMHC)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:NOELLE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MA CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2773 E 3630 S
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7283
Mailing Address - Country:US
Mailing Address - Phone:435-559-2357
Mailing Address - Fax:
Practice Address - Street 1:2480 RED CLIFFS DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5457
Practice Address - Country:US
Practice Address - Phone:435-673-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6508673-6009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional