Provider Demographics
NPI:1255039731
Name:KERRIGAN, KRISTEN (CF SLP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HENDRICKSON AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6155
Mailing Address - Country:US
Mailing Address - Phone:732-639-1551
Mailing Address - Fax:732-335-6759
Practice Address - Street 1:4 HENDRICKSON AVE STE 4
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-6155
Practice Address - Country:US
Practice Address - Phone:732-639-1551
Practice Address - Fax:732-335-6759
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-3828235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty