Provider Demographics
NPI:1750714622
Name:TRIPP, KRISTEN M (MS,SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:M
Last Name:TRIPP
Suffix:
Gender:F
Credentials:MS,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 E BLACK ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5342
Mailing Address - Country:US
Mailing Address - Phone:803-980-2060
Mailing Address - Fax:803-980-2070
Practice Address - Street 1:414 E BLACK ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5342
Practice Address - Country:US
Practice Address - Phone:803-980-2060
Practice Address - Fax:803-980-2070
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist