Healthcare Provider Details

I. General information

NPI: 1093552168
Provider Name (Legal Business Name): KRISTINA MARIE ZARETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA ANDONISIO M.A., CCC-SLP

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5877 LIVERNOIS RD STE 101
TROY MI
48098-3100
US

IV. Provider business mailing address

5877 LIVERNOIS RD STE 101
TROY MI
48098-3100
US

V. Phone/Fax

Practice location:
  • Phone: 248-828-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101009044
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: