Provider Demographics
NPI:1477839785
Name:UMPHLETT, KRISTEN LEIGH (AUD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LEIGH
Last Name:UMPHLETT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:LEIGH
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 ABBOT RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1222
Mailing Address - Country:US
Mailing Address - Phone:517-332-0100
Mailing Address - Fax:
Practice Address - Street 1:1500 ABBOT RD
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1222
Practice Address - Country:US
Practice Address - Phone:517-332-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000588231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist