Provider Demographics
NPI:1417355371
Name:MORRIS, KRISTIN (SLP-A)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 E 19TH ST APT F6
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-3162
Mailing Address - Country:US
Mailing Address - Phone:870-853-7874
Mailing Address - Fax:
Practice Address - Street 1:625 E 19TH ST APT F6
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-3162
Practice Address - Country:US
Practice Address - Phone:870-853-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR14-01422355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant