Kyrsten Ann Bandholz
Individual provider Active NPI Speech-Language Pathologist · Cookeville, TN
NPI 1063296390 · NPPES record last updated Aug 18, 2023
Key facts
- NPI
- 1063296390
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 1610 Bobby Nichols Dr
Cookeville, TN 38506-5787 - Phone
- (610) 927-7766
- NPI assigned
- Aug 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals Eastern Pennsylvania | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
1610 Bobby Nichols Dr
Cookeville, TN 38506-5787
Mailing address
1610 Bobby Nichols Dr
Cookeville, TN 38506-5787
Phone (610) 927-7766
Other providers in Cookeville, TN
- Sandra L Bailiff
- Jeri Lynn Baker
- Whitney Carol Baker
- Emily Nichole Ball
- Marianna Boyles Ballard
- Judy Barclay
- Melinda Barker-Mutchmore
- Melanie Susanne Barker
- Betty Ann Barnes
- Chassidy Barnes
All providers in Cookeville, TN · Speech-Language Pathologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.