Provider Demographics
NPI:1013152271
Name:SENTER, KRISTI L (SPEECH-LANGUAGE PATH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:L
Last Name:SENTER
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 BATTLEGROUND DR
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852-1042
Mailing Address - Country:US
Mailing Address - Phone:662-423-2633
Mailing Address - Fax:662-423-2988
Practice Address - Street 1:1309 BATTLEGROUND DR
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-1042
Practice Address - Country:US
Practice Address - Phone:662-423-2633
Practice Address - Fax:662-423-2988
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2306235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSS2306OtherSPEECH LICENSE