Provider Demographics
NPI:1548615636
Name:DUPLANTIS, KRISTINA ZANNIS (BCBA, SLPA)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:ZANNIS
Last Name:DUPLANTIS
Suffix:
Gender:F
Credentials:BCBA, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5175 45TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-2266
Mailing Address - Country:US
Mailing Address - Phone:727-748-4060
Mailing Address - Fax:
Practice Address - Street 1:5175 45TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-2266
Practice Address - Country:US
Practice Address - Phone:727-748-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 174400000X
FLSI25442355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019877300Medicaid