Provider Demographics
NPI:1326272345
Name:KIRKPATRICK, MISTY KAY (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:KAY
Last Name:KIRKPATRICK
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 1:1544 APPLE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-7368
Mailing Address - Country:US
Mailing Address - Phone:252-414-8471
Mailing Address - Fax:
Practice Address - Street 1:1 COURT SQ
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-3701
Practice Address - Country:US
Practice Address - Phone:252-414-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000716235Z00000X
NC7988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist