Individual
MS. KRISTINA L WAYT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11310 HURON ST, NORTHGLENN, CO 80234-3046
(303) 450-7435
(303) 450-7436
Mailing address
PO BOX 856, ANTIOCH, IL 60002-0856
(847) 903-5604
(224) 788-5112
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
09926811
CO
1041C0700X
Clinical Social Worker
09926811
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09926811
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000187411
—
CO
Enumeration date
09/02/2020
Last updated
03/02/2023
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