Provider Demographics
NPI:1295067585
Name:REED, KRISTIN M
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1211
Mailing Address - Country:US
Mailing Address - Phone:207-781-8881
Mailing Address - Fax:207-781-8855
Practice Address - Street 1:50 DEPOT RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1211
Practice Address - Country:US
Practice Address - Phone:207-781-8881
Practice Address - Fax:207-781-8855
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST 1972235Z00000X
MESP 2064235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MESP 2064OtherTHERAPY LICENSE NUMBER
MEST 1972OtherTHERAPY LICENSE NUMBER