Provider Demographics
NPI:1851629976
Name:YOUNT, KRISTA DAWN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:DAWN
Last Name:YOUNT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 HEDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0689
Mailing Address - Country:US
Mailing Address - Phone:573-999-4045
Mailing Address - Fax:
Practice Address - Street 1:3402 HEDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-0689
Practice Address - Country:US
Practice Address - Phone:573-999-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005039925235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist