Provider Demographics
NPI:1942550926
Name:RICH, KRISTINA M
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:M
Last Name:RICH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KRISTINA
Other - Middle Name:M
Other - Last Name:COGLITORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3800 N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470
Mailing Address - Country:US
Mailing Address - Phone:585-638-6316
Mailing Address - Fax:585-638-7409
Practice Address - Street 1:3800 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470
Practice Address - Country:US
Practice Address - Phone:585-638-6316
Practice Address - Fax:585-638-7409
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022608235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist