Doctor Name: | KRISTINA EASTERBROOK |
NPI Number: | 1154419323 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SP12883 |
Business Practice Address: | 1001 E Cooley Dr Ste 101 Colton, CA - 923243941 |
Business Phone Number: | 9097831111 |
Business Fax Number: | 9097833957 |
Mailing Address: | 1001 E Cooley Dr, Ste 101 COLTON |
State: | CA |
Postal Code: | 923243941 |
Phone Number: | 9097831111 |
Fax Number: | 9097833957 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP12883 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |