Provider Demographics
NPI:1689901092
Name:O'NEILL, KIRSTEN A (SLP)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:A
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WOODRUFF AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3467
Mailing Address - Country:US
Mailing Address - Phone:401-782-0500
Mailing Address - Fax:401-788-2253
Practice Address - Street 1:14 WOODRUFF AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3467
Practice Address - Country:US
Practice Address - Phone:401-782-0500
Practice Address - Fax:401-788-2253
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00568235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist