Provider Demographics
NPI:1407807373
Name:DARLING-GREEN, KRISTEN ELLEN (CCCA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELLEN
Last Name:DARLING-GREEN
Suffix:
Gender:F
Credentials:CCCA
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:ELLEN
Other - Last Name:DARLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:160 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3191
Mailing Address - Country:US
Mailing Address - Phone:406-752-8330
Mailing Address - Fax:406-752-8412
Practice Address - Street 1:160 HERITAGE WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3191
Practice Address - Country:US
Practice Address - Phone:406-752-8330
Practice Address - Fax:406-752-8412
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1054231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0561884Medicaid
MT0534106Medicaid
MT0534106Medicaid