Provider Demographics
NPI:1780726596
Name:HOWARD, KRISTIN JARVIS (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:JARVIS
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13725 E VIA VALDERAMA
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-6492
Mailing Address - Country:US
Mailing Address - Phone:520-907-1338
Mailing Address - Fax:
Practice Address - Street 1:13725 E VIA VALDERAMA
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-6492
Practice Address - Country:US
Practice Address - Phone:520-907-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP2059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ724717Medicaid