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Individual
TRISTA PUTT
Active
Individual
TRISTA PUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
PC007115
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103428968
—
PA
Enumeration date
09/03/2009
Last updated
06/24/2019
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