Doctor Name: | KRISTEN AMBER HANNIFAN |
NPI Number: | 1881938975 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | TSLP-2267 |
Business Practice Address: | 179 Sw 5th Ave Meridian, ID - 836422995 |
Business Phone Number: | 2083678282 |
Business Fax Number: | |
Mailing Address: | 179 Sw 5th Ave, MERIDIAN |
State: | ID |
Postal Code: | 836422995 |
Phone Number: | 2083678282 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP-2267 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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 |