Provider Demographics
NPI:1669590139
Name:SOWASH, KRISTI LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNN
Last Name:SOWASH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:LYNN
Other - Last Name:HEPBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:106 COLYER RD
Mailing Address - City:CENTRE HALL
Mailing Address - State:PA
Mailing Address - Zip Code:16828-0463
Mailing Address - Country:US
Mailing Address - Phone:814-525-1760
Mailing Address - Fax:814-472-0827
Practice Address - Street 1:ROUTE 220 MEADOWS INTERSECTION
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648
Practice Address - Country:US
Practice Address - Phone:814-695-2999
Practice Address - Fax:814-696-5525
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008751235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist