Provider Demographics
NPI:1689823510
Name:SMITH, KRISTEN LEE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 E GALBRAITH RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6703
Mailing Address - Country:US
Mailing Address - Phone:513-936-4824
Mailing Address - Fax:513-791-1152
Practice Address - Street 1:4760 E GALBRAITH RD
Practice Address - Street 2:SUITE 111
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6703
Practice Address - Country:US
Practice Address - Phone:513-936-4824
Practice Address - Fax:513-791-1152
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-01303231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSM4081981Medicare PIN