Provider Demographics
NPI:1912408501
Name:DRAKE, KRISTIN L (BS, SLP-A)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:L
Last Name:DRAKE
Suffix:
Gender:F
Credentials:BS, SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 BARCHETTA TRL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3039
Mailing Address - Country:US
Mailing Address - Phone:504-975-3327
Mailing Address - Fax:
Practice Address - Street 1:4323 BARCHETTA TRL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3039
Practice Address - Country:US
Practice Address - Phone:504-975-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist