Provider Demographics
NPI:1528585643
Name:LOBMAN, KRISTEN R (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:R
Last Name:LOBMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:KRISTEN
Other - Middle Name:R
Other - Last Name:MATOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:491 BLOOMFIELD AVE UNIT 204
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3406
Mailing Address - Country:US
Mailing Address - Phone:862-621-9390
Mailing Address - Fax:
Practice Address - Street 1:491 BLOOMFIELD AVE STE 204
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3406
Practice Address - Country:US
Practice Address - Phone:862-621-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00820700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist