Provider Demographics
NPI:1477884096
Name:CARR, KRISTEN MICHELLE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:CARR
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 1:13985 W GRAND AVE
Mailing Address - Street 2:STE. 101
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3625
Mailing Address - Country:US
Mailing Address - Phone:623-266-8490
Mailing Address - Fax:623-266-4611
Practice Address - Street 1:13985 W GRAND AVE
Practice Address - Street 2:STE. 101
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3625
Practice Address - Country:US
Practice Address - Phone:623-266-8490
Practice Address - Fax:623-266-4611
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA6474231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist