Provider Demographics
NPI:1376724385
Name:DECELLES, KRISTEN HERRMANN (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:HERRMANN
Last Name:DECELLES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:H
Other - Last Name:DECELLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:3825 HENDERSON BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5032
Mailing Address - Country:US
Mailing Address - Phone:813-751-2263
Mailing Address - Fax:
Practice Address - Street 1:3825 HENDERSON BLVD STE 600
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5032
Practice Address - Country:US
Practice Address - Phone:813-751-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1310237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter