Provider Demographics
NPI:1346724895
Name:DE MEO, KRISTIN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:DE MEO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21325 EVA ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-1967
Mailing Address - Country:US
Mailing Address - Phone:936-463-1788
Mailing Address - Fax:346-202-0123
Practice Address - Street 1:21325 EVA ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-1967
Practice Address - Country:US
Practice Address - Phone:832-808-5942
Practice Address - Fax:346-202-0123
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist