Provider Demographics
NPI:1720416324
Name:EVANS, KRISTI RENEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:RENEE
Last Name:EVANS
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 1:5521 HEDGE BROOKE DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7139
Mailing Address - Country:US
Mailing Address - Phone:678-654-2033
Mailing Address - Fax:
Practice Address - Street 1:5521 HEDGE BROOKE DR NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-7139
Practice Address - Country:US
Practice Address - Phone:678-654-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008316235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist