Provider Demographics
NPI:1013296862
Name:VETETO, KRISTIN NOEL (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:NOEL
Last Name:VETETO
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919B CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2913
Mailing Address - Country:US
Mailing Address - Phone:309-221-3198
Mailing Address - Fax:
Practice Address - Street 1:919B CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2913
Practice Address - Country:US
Practice Address - Phone:309-221-3198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO09621225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist