Provider Demographics
NPI:1003992272
Name:KRISTAL HILL INC
Entity Type:Organization
Organization Name:KRISTAL HILL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTAL
Authorized Official - Middle Name:MOURIE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:479-996-0663
Mailing Address - Street 1:170 AZALEA DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-3401
Mailing Address - Country:US
Mailing Address - Phone:479-996-5202
Mailing Address - Fax:479-996-2110
Practice Address - Street 1:1405 WEST CENTER
Practice Address - Street 2:SUITE 204
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-3401
Practice Address - Country:US
Practice Address - Phone:479-996-0663
Practice Address - Fax:479-996-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty