Provider Demographics
NPI:1669597373
Name:DUGGAN, KRISTEN L (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2500
Mailing Address - Country:US
Mailing Address - Phone:319-268-3000
Mailing Address - Fax:
Practice Address - Street 1:515 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2500
Practice Address - Country:US
Practice Address - Phone:319-268-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01021235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist