Provider Demographics
NPI:1255506184
Name:MCPHILLIPS, KRISTEN M
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:M
Last Name:MCPHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 HONEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1044
Mailing Address - Country:US
Mailing Address - Phone:773-896-5645
Mailing Address - Fax:
Practice Address - Street 1:10002 HONEYWOOD DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1044
Practice Address - Country:US
Practice Address - Phone:773-896-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008289235Z00000X
HISP-991235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist