Provider Demographics
NPI:1104015171
Name:GAYMON, KRISTIN (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:
Last Name:GAYMON
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 1:3807 SWANN RD
Mailing Address - Street 2:#101
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2241
Mailing Address - Country:US
Mailing Address - Phone:202-486-5015
Mailing Address - Fax:
Practice Address - Street 1:231 44TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3419
Practice Address - Country:US
Practice Address - Phone:240-604-8559
Practice Address - Fax:301-420-0831
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist