Healthcare Provider Details

I. General information

NPI: 1245309673
Provider Name (Legal Business Name): KRISTINE ANNE HOTCHKISS M.A., CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 SPIDER MONKEY CT.
COLUMBIA MO
65202-6297
US

IV. Provider business mailing address

505 SPIDER MONKEY CT.
COLUMBIA MO
65202-6297
US

V. Phone/Fax

Practice location:
  • Phone: 573-447-1719
  • Fax:
Mailing address:
  • Phone: 573-447-1171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2000173369
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: