Healthcare Provider Details

I. General information

NPI: 1770837387
Provider Name (Legal Business Name): KRISTEN WRIGHT ARNETTE M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2012
Last Update Date: 11/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5374 10TH ST
MALONE FL
32445-3429
US

IV. Provider business mailing address

5374 10TH ST
MALONE FL
32445-3429
US

V. Phone/Fax

Practice location:
  • Phone: 850-209-3607
  • Fax:
Mailing address:
  • Phone: 850-209-3607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA10730
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: