Provider Demographics
NPI:1689866261
Name:MALLETT, KRISTEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:
Last Name:MALLETT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2907
Mailing Address - Country:US
Mailing Address - Phone:617-359-9389
Mailing Address - Fax:
Practice Address - Street 1:462 BOSTON ST
Practice Address - Street 2:COUNSELING ASSOCIATES, SUITE 7
Practice Address - City:TOPSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01983-1200
Practice Address - Country:US
Practice Address - Phone:617-359-9389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1140235Z00000X
MA4932235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist