Provider Demographics
NPI:1801576251
Name:WALTER, KRISTEN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 SW REGENCY PKWY STE 5
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7488
Mailing Address - Country:US
Mailing Address - Phone:479-252-3321
Mailing Address - Fax:
Practice Address - Street 1:3201 SW REGENCY PKWY STE 5
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7488
Practice Address - Country:US
Practice Address - Phone:479-252-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist