Provider Demographics
NPI:1194181180
Name:KUNTEMEIER, KRISTY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:KUNTEMEIER
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 1:1502 PATRICK WAY
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3319
Mailing Address - Country:US
Mailing Address - Phone:561-596-2292
Mailing Address - Fax:
Practice Address - Street 1:12785 FOREST HILL BLVD
Practice Address - Street 2:SUITE 8G
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4777
Practice Address - Country:US
Practice Address - Phone:561-753-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 13977235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist