Provider Demographics
NPI:1073933248
Name:BERNDT, KRISTIN ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:BERNDT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ELIZABETH
Other - Last Name:FOLK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:119 CLINICAL SCIENCES BUILDING
Mailing Address - Street 2:150 SOUTH RD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-7046
Mailing Address - Country:US
Mailing Address - Phone:507-389-1543
Mailing Address - Fax:507-389-2821
Practice Address - Street 1:119 CLINICAL SCIENCES BUILDING
Practice Address - Street 2:150 SOUTH RD
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-7046
Practice Address - Country:US
Practice Address - Phone:507-389-1543
Practice Address - Fax:507-389-2821
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1006764235Z00000X
MN9095235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist