Provider Demographics
NPI:1710446356
Name:WATERS, KRISTEN GOLDING (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:GOLDING
Last Name:WATERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:GOLDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1660 E BOOKER DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9405
Mailing Address - Country:US
Mailing Address - Phone:919-938-3824
Mailing Address - Fax:919-938-3824
Practice Address - Street 1:1660 E BOOKER DAIRY RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9405
Practice Address - Country:US
Practice Address - Phone:919-938-3824
Practice Address - Fax:919-938-3824
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist