Healthcare Provider Details

I. General information

NPI: 1427964121
Provider Name (Legal Business Name): MRS. KRISTIN ANSLEY WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KRISTIN ANSLEY CLEMENTS

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 HIGHWAY 29 N
ATHENS GA
30601-1547
US

IV. Provider business mailing address

1215 BRIDGE CREST DR
WINDER GA
30680-3382
US

V. Phone/Fax

Practice location:
  • Phone: 706-770-1705
  • Fax:
Mailing address:
  • Phone: 478-251-0772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP012318
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: