Doctor Name: | KRISTINE FANGMAN |
NPI Number: | 1649675307 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CFY SLP |
License Number: | 075144 |
Business Practice Address: | 2109 Cedarwood Dr Ste 200 Muscatine, IA - 527612670 |
Business Phone Number: | 5632630557 |
Business Fax Number: | |
Mailing Address: | 3307 Mackinac Ct, MUSCATINE |
State: | IA |
Postal Code: | 527612353 |
Phone Number: | 5635062737 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2014 |
NPI Last Update Date: | 10/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 075144 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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 |