Provider Demographics
NPI:1760732457
Name:JONES, KRISTEN DORSEY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DORSEY
Last Name:JONES
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:44025 PIPELINE PLZ STE 105
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5886
Mailing Address - Country:US
Mailing Address - Phone:703-723-7270
Mailing Address - Fax:703-740-8758
Practice Address - Street 1:44025 PIPELINE PLZ STE 105
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5886
Practice Address - Country:US
Practice Address - Phone:703-723-7270
Practice Address - Fax:703-740-8758
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist