Provider Demographics
NPI:1841461811
Name:KING, KRISTEN HOWZE (AUD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:HOWZE
Last Name:KING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6018 SANDY SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3832
Mailing Address - Country:US
Mailing Address - Phone:404-256-5194
Mailing Address - Fax:404-256-5151
Practice Address - Street 1:2424 ROSWELL RD
Practice Address - Street 2:STE 140
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4759
Practice Address - Country:US
Practice Address - Phone:678-560-0011
Practice Address - Fax:678-560-7009
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003632231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I640045Medicare PIN