Provider Demographics
NPI:1316596232
Name:CURTIS, KIERSTIN ELIZABETH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KIERSTIN
Middle Name:ELIZABETH
Last Name:CURTIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 SAVOY DR APT 215
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-6835
Mailing Address - Country:US
Mailing Address - Phone:318-791-5535
Mailing Address - Fax:
Practice Address - Street 1:2602 S BELT LINE RD
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-5344
Practice Address - Country:US
Practice Address - Phone:972-264-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist