Provider Demographics
NPI:1518634591
Name:OGDEN, KRISTEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:OGDEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 TOWHEE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-8434
Mailing Address - Country:US
Mailing Address - Phone:318-465-1215
Mailing Address - Fax:
Practice Address - Street 1:2226 MURPHY ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-2549
Practice Address - Country:US
Practice Address - Phone:318-603-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist