Provider Demographics
NPI:1013324771
Name:DOTSON, KRISTA MICHELLE (SLP)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:MICHELLE
Last Name:DOTSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:KRISTA
Other - Middle Name:MICHELLE
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 TWIN OAK
Mailing Address - Street 2:
Mailing Address - City:ADKINS
Mailing Address - State:TX
Mailing Address - Zip Code:78101-2311
Mailing Address - Country:US
Mailing Address - Phone:210-201-6677
Mailing Address - Fax:
Practice Address - Street 1:330 TWIN OAK
Practice Address - Street 2:
Practice Address - City:ADKINS
Practice Address - State:TX
Practice Address - Zip Code:78101-2311
Practice Address - Country:US
Practice Address - Phone:210-201-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110326235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110326OtherPROFESSIONAL LICENSE- SPEECH LANGUAGE PATHOLOGIST