Provider Demographics
NPI:1679705453
Name:GULATI, KRISTINA LYNN (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:LYNN
Last Name:GULATI
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LYNN
Other - Last Name:DUGGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:6 ECHO AVE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2417
Mailing Address - Country:US
Mailing Address - Phone:978-927-7070
Mailing Address - Fax:
Practice Address - Street 1:6 ECHO AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2417
Practice Address - Country:US
Practice Address - Phone:978-927-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7126174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist