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General NPI Number Information
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NPI Number | 1114048089
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Entity Type | Individual
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Provider Name | KRISTI MARCUM MA CCC SLP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 13TH ST
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City | HUNTINGTON
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State | WV
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Zip | 25701-1653
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Country | US
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Telephone | 304-696-6939
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Fax | 304-529-1366
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Provider Business Mailing Address
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Address Line | 1005 TRUDE CT
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City | CATLETTSBURG
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State | KY
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Zip | 41129-9069
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Country | US
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Telephone | 606-739-9852
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Fax | 606-739-9852
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0858
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2303
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License Number State | KY
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