Provider Demographics
NPI:1669629861
Name:MUSTEEN, KRISTEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:MUSTEEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:GASSMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:6 MURROW LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-4815
Mailing Address - Country:US
Mailing Address - Phone:479-936-4122
Mailing Address - Fax:
Practice Address - Street 1:9649 W PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72713-2004
Practice Address - Country:US
Practice Address - Phone:417-455-0907
Practice Address - Fax:417-451-8855
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist