Provider Demographics
NPI:1790439933
Name:CRAIN, KRISTI (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:CRAIN
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 1:2412 MOUNTAIN FALLS CT
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5590
Mailing Address - Country:US
Mailing Address - Phone:832-385-2821
Mailing Address - Fax:
Practice Address - Street 1:4715 MUSTANG RD
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-5474
Practice Address - Country:US
Practice Address - Phone:281-245-2358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist