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NPI 1285520999

NPI 1285520999 : KRISTIN NOEL BIVENS : WOODLAND, WA

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General NPI Number Information
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    NPI Number           |    1285520999
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTIN NOEL BIVENS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/17/2025
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    Last Update Date     |    06/17/2025
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Provider Practice Location Address
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    Address Line         |    1900 BELMONT LOOP 
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    City                 |    WOODLAND
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    State                |    WA
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    Zip                  |    98674-8475
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    Country              |    US
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    Telephone            |    360-841-8096
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    Fax                  |    360-326-1599
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Provider Business Mailing Address
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    Address Line         |    647 GUN CLUB RD 
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    City                 |    WOODLAND
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    State                |    WA
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    Zip                  |    98674-8361
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    Country              |    US
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    Telephone            |    360-841-8096
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    Fax                  |    360-326-1599
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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       |    SLPI.SI.70001382
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    License Number State |    WA
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