Provider Demographics
NPI:1770035305
Name:HARROLD, KRISTEN (MS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HARROLD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 WATERSTONE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6847
Mailing Address - Country:US
Mailing Address - Phone:858-333-2873
Mailing Address - Fax:
Practice Address - Street 1:2507 WATERSTONE LN
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6847
Practice Address - Country:US
Practice Address - Phone:858-333-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist