Provider Demographics
NPI:1073210746
Name:BARTON, KRISTIN ROYLEEN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ROYLEEN
Last Name:BARTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MARGARET RD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-3543
Mailing Address - Country:US
Mailing Address - Phone:724-301-3310
Mailing Address - Fax:
Practice Address - Street 1:66 MARGARET RD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-3543
Practice Address - Country:US
Practice Address - Phone:724-301-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13752235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty