Provider Demographics
NPI:1366162091
Name:KRISTIN GROTHE ARANGO, PSYD
Entity type:Organization
Organization Name:KRISTIN GROTHE ARANGO, PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTHE ARANGO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:407-830-6033
Mailing Address - Street 1:815 ORIENTA AVE STE 1010
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5624
Mailing Address - Country:US
Mailing Address - Phone:407-830-6033
Mailing Address - Fax:
Practice Address - Street 1:815 ORIENTA AVE STE 1010
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5624
Practice Address - Country:US
Practice Address - Phone:407-830-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5924OtherFLORIDA LICENSE NUMBER PY#5924