| Organization Name: | KRISTINA MCMENAMY PSYD LLC |
| NPI Number: | 1417195306 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTINA ANNE MCMENAMY (MEMBER) |
| Mailing Address: | 1845 Cypress Lake Dr Grant |
| State: | FL US |
| Postal Code: | 329495330 |
| Phone Number: | 7726072293 |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2009 |
| NPI Last Update Date: | 01/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY7481 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |