Provider Demographics
NPI:1760546188
Name:SHAFFER, KRISTI HOOTS (MA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:HOOTS
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7834
Mailing Address - Country:US
Mailing Address - Phone:336-885-2033
Mailing Address - Fax:336-476-3888
Practice Address - Street 1:110 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7834
Practice Address - Country:US
Practice Address - Phone:336-885-2033
Practice Address - Fax:336-476-3888
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist