Provider Demographics
NPI:1265463889
Name:GALEK, KRISTINE (PHD CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:
Last Name:GALEK
Suffix:
Gender:F
Credentials:PHD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 N VIRGINIA ST
Mailing Address - Street 2:MS 0152
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0152
Mailing Address - Country:US
Mailing Address - Phone:775-682-7021
Mailing Address - Fax:775-784-4095
Practice Address - Street 1:1664 N VIRGINIA ST
Practice Address - Street 2:MS 0152
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0152
Practice Address - Country:US
Practice Address - Phone:775-682-7021
Practice Address - Fax:775-784-4095
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3035235Z00000X
CA17741235Z00000X
NV1246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211624Medicaid
NC7434358Medicaid