Provider Demographics
NPI:1376071688
Name:CYR, KRISTY MICHELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:MICHELLE
Last Name:CYR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4872 S VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-9123
Mailing Address - Country:US
Mailing Address - Phone:417-820-2051
Mailing Address - Fax:417-820-7783
Practice Address - Street 1:1235 E CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2203
Practice Address - Country:US
Practice Address - Phone:417-820-2051
Practice Address - Fax:417-820-7783
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist