Provider Demographics
NPI:1659612679
Name:WHITEFORD, KRISTEN STELLANN
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:STELLANN
Last Name:WHITEFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:STELLANN
Other - Last Name:PEARCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:811 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BELLWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:16617-1128
Mailing Address - Country:US
Mailing Address - Phone:814-207-6683
Mailing Address - Fax:
Practice Address - Street 1:360 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2737
Practice Address - Country:US
Practice Address - Phone:814-644-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist