Provider Demographics
NPI:1891956140
Name:BROWN, KRISTY (MS,CCC,SLP/L)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS,CCC,SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 FOX MEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-2564
Mailing Address - Country:US
Mailing Address - Phone:814-880-1453
Mailing Address - Fax:
Practice Address - Street 1:1213 FOX MEADOW CIR
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2564
Practice Address - Country:US
Practice Address - Phone:814-880-1453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist