Provider Demographics
NPI:1689705691
Name:HUBBARD, KRISTI GRAVES (MED,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:GRAVES
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MED,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 PROVIDENCE PL
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1011
Mailing Address - Country:US
Mailing Address - Phone:504-957-7762
Mailing Address - Fax:504-218-7097
Practice Address - Street 1:6260 PROVIDENCE PL
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1011
Practice Address - Country:US
Practice Address - Phone:504-957-7762
Practice Address - Fax:504-218-7097
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist