Doctor Name: | KRISTINE C MATTHIAS |
NPI Number: | 1306241005 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 5349 |
Business Practice Address: | 807 University Pkwy Lamb Hall Rm 361 Johnson City, TN - 376141702 |
Business Phone Number: | 4234394584 |
Business Fax Number: | 4234394607 |
Mailing Address: | 807 University Pkwy Box 70403, JOHNSON CITY |
State: | TN |
Postal Code: | 376141703 |
Phone Number: | 4234394071 |
Fax Number: | 4234394060 |
NPI Enumeration Date: | 10/24/2014 |
NPI Last Update Date: | 10/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5349 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |