Provider Demographics
NPI:1427816719
Name:HARRIS, KRISTA
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 ARAPAHOE AVE UNIT 413
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1077
Mailing Address - Country:US
Mailing Address - Phone:267-226-5019
Mailing Address - Fax:
Practice Address - Street 1:3301 ARAPAHOE AVE UNIT 413
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1077
Practice Address - Country:US
Practice Address - Phone:267-226-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health