Provider Demographics
NPI:1770837387
Name:ARNETTE, KRISTEN WRIGHT (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:WRIGHT
Last Name:ARNETTE
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 1:5374 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:FL
Mailing Address - Zip Code:32445-3429
Mailing Address - Country:US
Mailing Address - Phone:850-209-3607
Mailing Address - Fax:
Practice Address - Street 1:5374 10TH ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:FL
Practice Address - Zip Code:32445-3429
Practice Address - Country:US
Practice Address - Phone:850-209-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-04
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist