Kirstin Bolton, MA CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Missoula, MT

NPI 1770841199 · NPPES record last updated Apr 24, 2012

Key facts

NPI
1770841199
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1324 (MT)
Practice address
1931 S 3Rd St W
Missoula, MT 59801-2241
Phone
(406) 829-6349
NPI assigned
Apr 24, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
1324MTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Above & Beyond Speech Therapy Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1324 MT Yes

Addresses

Primary practice location

1931 S 3Rd St W
Missoula, MT 59801-2241

Mailing address

1931 S 3Rd St W
Missoula, MT 59801-2241

Other providers in Missoula, MT

All providers in Missoula, MT · Speech-Language Pathologist in Montana

Sources for this page

Verify at the official NPI Registry.