MEDICARE: MS. COLLEEN ANN KRIZAK M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	113460	TX

General Provider Information

NPI Number	:	1861972762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. COLLEEN ANN KRIZAK M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	4033 MOORHEAD DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-5522
Country	:	US
Telephone Number	:	210-792-6332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 S TERRELL ST
Second Line	:
City	:	FALFURRIAS
State	:	TX
Zip	:	78355-4902
Country	:	US
Telephone Number	:	361-325-3658
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	06/11/2019

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Directions to “ MS. COLLEEN ANN KRIZAK M.S. CCC-SLP” Practice Location

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