Kristina Michele Elliott, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Rexburg, ID
NPI 1366923955 · NPPES record last updated Aug 22, 2018
Key facts
- NPI
- 1366923955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP-3529 (ID)
- Practice address
- 859 S Yellowstone Hwy Ste 1701
Rexburg, ID 83440-5293 - Phone
- (208) 356-7643
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-3529 | ID | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP-3529 | ID | Yes |
Addresses
Primary practice location
859 S Yellowstone Hwy Ste 1701
Rexburg, ID 83440-5293
Mailing address
133 N 3736 E
Rigby, ID 83442-4935
Phone (408) 250-1085
Other providers in Rexburg, ID
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- Amie R Einerson
- Luke Einerson
- Jeffrey Lee Elder II
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- Angela Luana Ellis
- Embody Health
- Tanya Espinoza
- Edward E Evans
- Sadie N. Evans
All providers in Rexburg, ID · Speech-Language Pathologist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2018. 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.