Provider Demographics
NPI:1215201892
Name:NEUMYER, KRISTINA CHAMBERS (MS)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:CHAMBERS
Last Name:NEUMYER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1486
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81215-1486
Mailing Address - Country:US
Mailing Address - Phone:863-258-0482
Mailing Address - Fax:
Practice Address - Street 1:515 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2863
Practice Address - Country:US
Practice Address - Phone:719-275-0665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist