Kristina L Delong
Individual provider Active NPI Developmental Therapist · Wolcottville, IN
NPI 1609615608 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1609615608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 8490 E 600 S
Wolcottville, IN 46795-9756 - Phone
- (260) 318-6577
- NPI assigned
- May 21, 2024
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
8490 E 600 S
Wolcottville, IN 46795-9756
Mailing address
8490 E 600 S
Wolcottville, IN 46795-9756
Phone (260) 318-6577
NPI Registry JSON
{
"created_epoch": "1716249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716249600000",
"number": "1609615608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8490 E 600 S",
"city": "WOLCOTTVILLE",
"state": "IN",
"postal_code": "467959756",
"telephone_number": "260-318-6577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8490 E 600 S",
"city": "WOLCOTTVILLE",
"state": "IN",
"postal_code": "467959756",
"telephone_number": "260-318-6577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELONG",
"first_name": "KRISTINA",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-21",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wolcottville, IN
All providers in Wolcottville, IN · Developmental Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. 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.