Provider Demographics
NPI:1407566482
Name:VIEAU, KRISTEN JOY (AUD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:JOY
Last Name:VIEAU
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5639 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1250
Mailing Address - Country:US
Mailing Address - Phone:315-468-2985
Mailing Address - Fax:315-320-0245
Practice Address - Street 1:5639 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1250
Practice Address - Country:US
Practice Address - Phone:315-468-2985
Practice Address - Fax:315-320-0245
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003159231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist