Provider Demographics
NPI:1659199800
Name:RAYMOND, KRISTA L
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:RAYMOND
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 1:3657 BATTEE RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:OH
Mailing Address - Zip Code:43001-8707
Mailing Address - Country:US
Mailing Address - Phone:614-746-8632
Mailing Address - Fax:
Practice Address - Street 1:5 N. HIGH STREET
Practice Address - Street 2:
Practice Address - City:CROTON
Practice Address - State:OH
Practice Address - Zip Code:43013
Practice Address - Country:US
Practice Address - Phone:614-746-8632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program