Provider Demographics
NPI:1811681810
Name:SWINGLER, KRYSTEN (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRYSTEN
Middle Name:
Last Name:SWINGLER
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 1:11619 ORIOLE RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-5150
Mailing Address - Country:US
Mailing Address - Phone:217-556-1478
Mailing Address - Fax:
Practice Address - Street 1:20733 N BROAD ST
Practice Address - Street 2:
Practice Address - City:CARLINVILLE
Practice Address - State:IL
Practice Address - Zip Code:62626-3710
Practice Address - Country:US
Practice Address - Phone:217-854-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.014416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist