| Doctor Name: | MRS. KRISTINA NICHOLE TAYLOR CLEMMONS |
| NPI Number: | 1467743930 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC, LCAS-A |
| License Number: | 3394 |
| Business Practice Address: | 120 Coastal Horizons Dr Shallotte, NC - 284706094 |
| Business Phone Number: | 9107544515 |
| Business Fax Number: | |
| Mailing Address: | Po Box 8183, OCEAN ISLE BEACH |
| State: | NC |
| Postal Code: | 284692183 |
| Phone Number: | 9105797095 |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2011 |
| NPI Last Update Date: | 03/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 3394 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |