Provider Demographics
NPI:1265710701
Name:BATEMAN, KRISTIN JUDITH (MS, CCC-SLP, BCBA)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JUDITH
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-3040
Mailing Address - Country:US
Mailing Address - Phone:940-383-2721
Mailing Address - Fax:
Practice Address - Street 1:1400 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-3040
Practice Address - Country:US
Practice Address - Phone:940-383-2721
Practice Address - Fax:940-403-2550
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102842235Z00000X
1-16-22811103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst