Kristin Edwards, MA, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Kingsford, MI

NPI 1942862016 · NPPES record last updated Jun 28, 2019

Key facts

NPI
1942862016
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7101003468 (MI)
Practice address
1225 Woodward Ave
Kingsford, MI 49802-4312
Phone
(906) 774-4805
Fax
(906) 774-1901
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
No

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
7101003468MIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101003468 MI Yes

Addresses

Primary practice location

1225 Woodward Ave
Kingsford, MI 49802-4312

Mailing address

1225 Woodward Ave
Kingsford, MI 49802-4312

Other providers in Kingsford, MI

All providers in Kingsford, MI · Speech-Language Pathologist in Michigan

Sources for this page

Verify at the official NPI Registry.