Provider Demographics
NPI:1891095717
Name:LOFTIN-MOENING, KRISTY
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:LOFTIN-MOENING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847176
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7176
Mailing Address - Country:US
Mailing Address - Phone:903-237-1800
Mailing Address - Fax:903-237-1810
Practice Address - Street 1:709 HOLLYBROOK DR
Practice Address - Street 2:SUITE 5601
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2411
Practice Address - Country:US
Practice Address - Phone:903-236-7560
Practice Address - Fax:903-758-0246
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist