Provider Demographics
NPI:1093060428
Name:MASTERS, KRISTI ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:ANN
Last Name:MASTERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 OLD RANCH ROAD 12
Mailing Address - Street 2:APT. 605
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-2957
Mailing Address - Country:US
Mailing Address - Phone:210-632-3238
Mailing Address - Fax:
Practice Address - Street 1:448 SIDNEY BAKER ST S
Practice Address - Street 2:STE 102
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5915
Practice Address - Country:US
Practice Address - Phone:830-896-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15135235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist