Provider Demographics
NPI:1629634407
Name:SALVATO, KRISTEN LYNN (LICENSED PROFESSIONA)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LYNN
Last Name:SALVATO
Suffix:
Gender:F
Credentials:LICENSED PROFESSIONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 NORTH FORT THOMAS AVENUE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075
Mailing Address - Country:US
Mailing Address - Phone:859-866-4977
Mailing Address - Fax:859-448-5923
Practice Address - Street 1:18 NORTH FORT THOMAS AVENUE
Practice Address - Street 2:SUITE 109
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075
Practice Address - Country:US
Practice Address - Phone:859-866-4977
Practice Address - Fax:859-448-5923
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY247981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health