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General NPI Number Information
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NPI Number | 1144773995
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Entity Type | Individual
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Provider Name | KRISTIN HONG
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Gender | Female
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 1252 S AVONDALE BLVD
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City | AVONDALE
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State | AZ
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Zip | 85323-8900
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Country | US
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Telephone | 623-478-5702
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Fax |
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Provider Business Mailing Address
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Address Line | 18829 N 25TH ST
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City | PHOENIX
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State | AZ
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Zip | 85050-3116
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Country | US
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Telephone | 602-614-4601
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Fax |
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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 | TSLP10126
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License Number State | AZ
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